| NPI | 1700124237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL LIETZ Sole Member 616-530-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI L2083320) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |