| Obsidian Chiropractic, LLC | |
|
2504 Ardmore St Se Ste 102 Grand Rapids MI 49506-4901 | |
| (850) 218-0677 | |
| Not Available |
| Full Name | Obsidian Chiropractic, LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 2504 Ardmore St Se Ste 102, Grand Rapids, Michigan |
| Authorized Official Name and Position | Charles Justin Austin (OWNER) |
| Authorized Official Contact | 8502180677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Obsidian Chiropractic, LLC 319 Lyon St Ne Apt 1 Grand Rapids MI 49503-3381 Ph: (850) 218-0677 | Obsidian Chiropractic, LLC 2504 Ardmore St Se Ste 102 Grand Rapids MI 49506-4901 Ph: (850) 218-0677 |
| NPI Number | 1154967651 |
|---|---|
| Provider Enumeration Date | 11/20/2019 |
| Last Update Date | 11/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154967651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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