Organization
OPTIMAL WELLNESS FAMILY CHIROPRACTIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENDRA BERGMANN D.C. (OWNER)
(248) 792-6570
Entity
Organization
Contact information
Practice address
3302 CROOKS RD, ROYAL OAK, MI 48073-2446
(248) 629-6071
(248) 629-6071
Mailing address
3302 CROOKS RD, ROYAL OAK, MI 48073-2446
(248) 629-6071
(248) 629-6071
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009334
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP56370
MEDICARE PTAN
MI
Enumeration date
04/11/2008
Last updated
01/04/2016
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