Provider Demographics
NPI:1861086274
Name:CHIROPRACTIC FIRST OF MICHIGAN PLLC
Entity type:Organization
Organization Name:CHIROPRACTIC FIRST OF MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-482-8354
Mailing Address - Street 1:15700 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3905
Mailing Address - Country:US
Mailing Address - Phone:586-772-7770
Mailing Address - Fax:586-776-3250
Practice Address - Street 1:15700 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3905
Practice Address - Country:US
Practice Address - Phone:586-772-7770
Practice Address - Fax:586-776-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2301009815OtherLICENSE
1124319728OtherNPI TYPE 1