Organization
MED TECH ORTHO CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOM D HOPPER DC (OWNER)
(810) 247-3048
Entity
Organization
Contact information
Practice address
1048 CORYDON DR, MOUNT MORRIS, MI 48458-1630
(810) 247-3048
Mailing address
1048 CORYDON DR, MOUNT MORRIS, MI 48458-1630
(810) 247-3048
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301002505
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2301002505
MEDICAL LICENSE
MI
Enumeration date
08/30/2016
Last updated
09/28/2016
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