Organization
GREAT LAKES CHIROPRACTIC OF MICHIGAN PLLC
Active
Other names
GREAT LAKES CHIROPRACTIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW EDGAR ERICKSON D.C. (OWNER)
(231) 946-7800
Entity
Organization
Contact information
Practice address
2000 CHARTWELL DR, STE 2, TRAVERSE CITY, MI 49686-9348
(231) 946-7800
(231) 946-1800
Mailing address
2000 CHARTWELL DR, STE 2, TRAVERSE CITY, MI 49686-9348
(231) 946-7800
(231) 946-1800
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007661
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950B811590
BC/BS ID NUMBER
MI
Enumeration date
08/31/2006
Last updated
02/19/2008
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