Breath of Life Chiropractic Wellness Center P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009264 Issued in MI

Legal business name

BREATH OF LIFE CHIROPRACTIC WELLNESS CENTER P.C.

Practice address

322 Bay St
#3
Petoskey, MI 49770-2489

Phone

(231) 622-8828

Fax

(231) 622-8829

NPI assigned

May 13, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kyle Martin Denholm, D.C.NPI 1922129220

Title

Owner

Phone

(989) 619-4709

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Martin Denholm, D. C. B. S.

  • Chiropractor
  • Grayling, MI
  • NPI 1922129220
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1124252598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "address_2": "#3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-622-8828",
            "fax_number": "231-622-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "address_2": "#3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-622-8828",
            "fax_number": "231-622-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATH OF LIFE CHIROPRACTIC WELLNESS CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "DENHOLM",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-619-4709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5195192",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "950B01090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Brabant
• Akira Bradshaw
• Mark Braendle
• Linda Brant, RN
• Margaret M. Brazones, D.D.S., M.S.
• Lois Christine Brewer
• Brian B Lehky PHD PC
• Brian D Wittenberg
• Brian D Wittenberg MD PC
• Andrea Leigh Bricker, FNP

• Chiropractor in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.