Provider Demographics
NPI:1902917602
Name:RONNA KAY ERSHER DC PC
Entity Type:Organization
Organization Name:RONNA KAY ERSHER DC PC
Other - Org Name:8 MILE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ERSHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:313-891-1800
Mailing Address - Street 1:3702 E 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234
Mailing Address - Country:US
Mailing Address - Phone:313-891-1800
Mailing Address - Fax:313-891-1802
Practice Address - Street 1:3702 E 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234
Practice Address - Country:US
Practice Address - Phone:313-891-1800
Practice Address - Fax:313-891-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3269116Medicaid
U62800Medicare UPIN
MIDM28670Medicare ID - Type Unspecified