Provider Demographics
NPI:1164901476
Name:HOWARD CITY FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HOWARD CITY FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOMIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-937-9370
Mailing Address - Street 1:1907 N JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:TRUFANT
Mailing Address - State:MI
Mailing Address - Zip Code:49347-9735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:837 W SHAW ST
Practice Address - Street 2:
Practice Address - City:HOWARD CITY
Practice Address - State:MI
Practice Address - Zip Code:49329
Practice Address - Country:US
Practice Address - Phone:231-937-9370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty