| NPI | 1174722433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD MICHAEL LAKE Owner/President 517-622-8552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301008249) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |