Organization
LAKEVIEW CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY A MCMATH D.C. (PRESIDENT)
(810) 982-2700
Entity
Organization
Contact information
Practice address
2100 WATER ST, PORT HURON, MI 48060-2543
(810) 982-2700
(810) 982-5194
Mailing address
2100 WATER ST, PORT HURON, MI 48060-2543
(810) 982-2700
(810) 982-5194
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
BM006038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950G45234
BCBS OF MI
MI
01
—
BM006038
MI LICENSE
MI
Enumeration date
01/08/2007
Last updated
06/29/2020
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