Provider Demographics
NPI:1942715735
Name:HOUSE CALL CHIROPRACTIC AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:HOUSE CALL CHIROPRACTIC AND WELLNESS, PLLC
Other - Org Name:NEW BEGINNINGS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-375-2024
Mailing Address - Street 1:17575 N FRUITPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-1879
Mailing Address - Country:US
Mailing Address - Phone:517-980-4914
Mailing Address - Fax:
Practice Address - Street 1:603 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1456
Practice Address - Country:US
Practice Address - Phone:231-375-2024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-03
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty