Provider Demographics
NPI:1861992075
Name:LISA A. PRICE D.C.P.C.
Entity type:Organization
Organization Name:LISA A. PRICE D.C.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-532-6373
Mailing Address - Street 1:19361 E 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3904
Mailing Address - Country:US
Mailing Address - Phone:586-778-2323
Mailing Address - Fax:586-532-6372
Practice Address - Street 1:19361 E 10 MILE RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-3904
Practice Address - Country:US
Practice Address - Phone:586-778-2323
Practice Address - Fax:586-532-6372
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LISA A. PRICE D.C.P.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-14
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty