Provider Demographics
NPI:1316611197
Name:PURE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:PURE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-286-0163
Mailing Address - Street 1:207 W JOHN ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:MI
Mailing Address - Zip Code:49868-1126
Mailing Address - Country:US
Mailing Address - Phone:906-286-0163
Mailing Address - Fax:
Practice Address - Street 1:207 W JOHN ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:MI
Practice Address - Zip Code:49868-1126
Practice Address - Country:US
Practice Address - Phone:906-291-2323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center