Provider Demographics
NPI:1043390768
Name:HERFERT CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:HERFERT CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:B
Authorized Official - Last Name:HERFERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-853-7246
Mailing Address - Street 1:2506 S ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3817
Mailing Address - Country:US
Mailing Address - Phone:248-853-7246
Mailing Address - Fax:248-852-1815
Practice Address - Street 1:2506 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3817
Practice Address - Country:US
Practice Address - Phone:248-853-7246
Practice Address - Fax:248-852-1815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP95560OtherWORK COMP
MI950F35280OtherBLUE CROSS
MI950F35280OtherBLUE CROSS
U47605Medicare UPIN