Provider Demographics
NPI:1730351420
Name:ERIC DILTS PC
Entity type:Organization
Organization Name:ERIC DILTS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:DILTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-267-9888
Mailing Address - Street 1:15694 S US HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906
Mailing Address - Country:US
Mailing Address - Phone:517-267-9888
Mailing Address - Fax:517-267-9051
Practice Address - Street 1:15694 S US HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-1486
Practice Address - Country:US
Practice Address - Phone:517-267-9888
Practice Address - Fax:517-267-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty