Provider Demographics
NPI:1548269509
Name:GRATIOT CHIROPRACTIC HEALTH, PC
Entity type:Organization
Organization Name:GRATIOT CHIROPRACTIC HEALTH, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:I
Authorized Official - Last Name:BERRYO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-463-5564
Mailing Address - Street 1:318 WOODWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1827
Mailing Address - Country:US
Mailing Address - Phone:989-463-5564
Mailing Address - Fax:989-463-5898
Practice Address - Street 1:318 WOODWORTH AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1827
Practice Address - Country:US
Practice Address - Phone:989-463-5564
Practice Address - Fax:989-463-5898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1548269509OtherGROUP NPI NUMBER
MI0P16230Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER