Provider Demographics
NPI:1083072888
Name:A RODNICK CHIROPRACTIC PC
Entity Type:Organization
Organization Name:A RODNICK CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-853-0753
Mailing Address - Street 1:2685 UNION LAKE RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3560
Mailing Address - Country:US
Mailing Address - Phone:248-366-6378
Mailing Address - Fax:248-366-6386
Practice Address - Street 1:2685 UNION LAKE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-3560
Practice Address - Country:US
Practice Address - Phone:248-366-6378
Practice Address - Fax:248-366-6386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty