Provider Demographics
NPI: | 1245481449 |
---|---|
Name: | ACHIEVING HEALTH CHIROPRACTIC PLUS PC |
Entity type: | Organization |
Organization Name: | ACHIEVING HEALTH CHIROPRACTIC PLUS PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | DOUG |
Authorized Official - Middle Name: | JOHN |
Authorized Official - Last Name: | OBRYAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 734-420-3434 |
Mailing Address - Street 1: | 40020 FIVE MILE RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PLYMOUTH |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48170-2764 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 734-420-3434 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 40020 FIVE MILE RD |
Practice Address - Street 2: | |
Practice Address - City: | PLYMOUTH |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48170-2764 |
Practice Address - Country: | US |
Practice Address - Phone: | 734-420-3434 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-10-06 |
Last Update Date: | 2014-04-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MI | 2301009048 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Multi-Specialty |