Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2301010500 | MI |
N | 111NP0017X | Pediatric Chiropractor | 2301010500 | MI |
NPI | 1083142939 |
---|---|
Provider Name | Dr. Ann M Bishop |
First Address | Grand Rapids, MI 49506-1780 |
Second Address | Grand Rapids, MI 49506-1780 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2017 |
Last Update Date | 21/07/2020 |