Provider Demographics
NPI:1730401340
Name:SPINAL SOLUTIONS CHIROPRACTIC AND WELLNESS CENTER PLLC
Entity type:Organization
Organization Name:SPINAL SOLUTIONS CHIROPRACTIC AND WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SERENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-524-1187
Mailing Address - Street 1:55130 SHELBY RD STE A
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-1176
Mailing Address - Country:US
Mailing Address - Phone:586-992-6960
Mailing Address - Fax:586-992-6962
Practice Address - Street 1:55130 SHELBY RD STE A
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-1176
Practice Address - Country:US
Practice Address - Phone:586-992-6960
Practice Address - Fax:586-992-6962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009477261Q00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty