Provider Demographics
NPI:1033169263
Name:KARL CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:KARL CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:KARL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-425-8220
Mailing Address - Street 1:30935 ANN ARBOR TRL
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2481
Mailing Address - Country:US
Mailing Address - Phone:734-425-8220
Mailing Address - Fax:734-425-8221
Practice Address - Street 1:30935 ANN ARBOR TRL
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2481
Practice Address - Country:US
Practice Address - Phone:734-425-8220
Practice Address - Fax:734-425-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H20237OtherBLUE CROSS OF MICHIGAN
MI0H20237OtherBLUE CROSS OF MICHIGAN