Provider Demographics
NPI:1902885973
Name:CURRERI, ELLEN SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:SUE
Last Name:CURRERI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29230 RYAN ROAD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092
Mailing Address - Country:US
Mailing Address - Phone:586-757-3800
Mailing Address - Fax:586-751-3810
Practice Address - Street 1:29230 RYAN ROAD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092
Practice Address - Country:US
Practice Address - Phone:586-757-3800
Practice Address - Fax:586-751-3810
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E01584OtherBLUE CROSS/BLUE SHIELD
T97303Medicare UPIN
MI0E05056Medicare ID - Type Unspecified