Provider Demographics
NPI:1083962807
Name:KRAUSENECK CHIROPRACTIC, PLC
Entity Type:Organization
Organization Name:KRAUSENECK CHIROPRACTIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KRAUSENECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-465-7900
Mailing Address - Street 1:51 SOUTHBOUND GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2386
Mailing Address - Country:US
Mailing Address - Phone:586-465-7900
Mailing Address - Fax:586-465-2411
Practice Address - Street 1:51 SOUTHBOUND GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2386
Practice Address - Country:US
Practice Address - Phone:586-465-7900
Practice Address - Fax:586-465-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty