Provider Demographics
NPI:1538569587
Name:CORE HEALTH PLLC
Entity type:Organization
Organization Name:CORE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KALLIL
Authorized Official - Middle Name:I
Authorized Official - Last Name:KAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:313-695-1000
Mailing Address - Street 1:13700 MICHIGAN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3489
Mailing Address - Country:US
Mailing Address - Phone:313-695-1000
Mailing Address - Fax:313-218-1741
Practice Address - Street 1:13700 MICHIGAN AVE STE 200
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3489
Practice Address - Country:US
Practice Address - Phone:313-695-1000
Practice Address - Fax:313-218-1741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty