Provider Demographics
NPI:1043063258
Name:PLYMOUTH CHIROPRACTIC AND MASSAGE CENTER, PLLC
Entity Type:Organization
Organization Name:PLYMOUTH CHIROPRACTIC AND MASSAGE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-454-5600
Mailing Address - Street 1:1075 ANN ARBOR RD W
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2128
Mailing Address - Country:US
Mailing Address - Phone:734-454-5600
Mailing Address - Fax:734-454-5696
Practice Address - Street 1:1075 ANN ARBOR RD W
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2128
Practice Address - Country:US
Practice Address - Phone:734-454-5600
Practice Address - Fax:734-454-5696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty