| NPI | 1386096816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY SUE BOUCHARD Owner/President 248-906-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301007569) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2019-08-02 |