Provider Demographics
NPI:1508624677
Name:ABUNDANT CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:ABUNDANT CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOMBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-400-4477
Mailing Address - Street 1:806 S DOE TRL
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-8813
Mailing Address - Country:US
Mailing Address - Phone:989-400-4477
Mailing Address - Fax:
Practice Address - Street 1:330 S UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2504
Practice Address - Country:US
Practice Address - Phone:989-400-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty