Provider Demographics
NPI:1265392427
Name:ADVANCE CHIROPRACTIC CARE PC
Entity type:Organization
Organization Name:ADVANCE CHIROPRACTIC CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/D.C
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-301-2037
Mailing Address - Street 1:225 BROOKWOOD DR UNIT 13
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-1860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 BROOKWOOD DR UNIT 13
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1860
Practice Address - Country:US
Practice Address - Phone:586-301-2037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty