Legacy Family Chiropractic
Organization Active NPI Chiropractor · Comstock Park, MI
NPI 1881297950 · NPPES record last updated Nov 19, 2020
Key facts
- NPI
- 1881297950
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- LEGACY FAMILY CHIROPRACTIC
- Practice address
- 4064 Alpine Ave NW
Ste B
Comstock Park, MI 49321 - Phone
- (616) 965-1197
- NPI assigned
- Nov 19, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Stephane Bohemier, DC
- Title
- Owner
- Phone
- (616) 965-1197
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201207002108 | MI | Part B Supplier - Clinic/Group Practice | 4587076005 |
Receives reassigned benefits from 1 practitioner Practice locations: Comstock Park, MI |
National Provider Directory
Locations
4064 Alpine Ave NW
Ste B
Comstock Park, MI 49321
Phone (616) 965-1197
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
4064 Alpine Ave NW
Ste B
Comstock Park, MI 49321
Mailing address
4064 Alpine Ave NW
Ste B
Comstock Park, MI 49321
Phone (616) 965-1197
Other providers in Comstock Park, MI
- Sarah Jean Johnson
- Keith R Moulds OD PC
- Kent Pediatrics, PC
- Vicky Lynne Klaassen
- Daniel K Koschtial
- Carlie Little
- Mason Taylor Lopez
- Siew Kheng Loy-O'Shea
- Luminary Home Care LLC
- Megan Malinowski
All providers in Comstock Park, MI · Chiropractor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.