Provider Demographics
NPI:1104371970
Name:THE FIX CHIROPRACTIC GROUP PLLC
Entity Type:Organization
Organization Name:THE FIX CHIROPRACTIC GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-860-3481
Mailing Address - Street 1:2839 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:KEEGO HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48320-1448
Mailing Address - Country:US
Mailing Address - Phone:248-681-7655
Mailing Address - Fax:248-681-4088
Practice Address - Street 1:2839 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:KEEGO HARBOR
Practice Address - State:MI
Practice Address - Zip Code:48320-1448
Practice Address - Country:US
Practice Address - Phone:248-681-7655
Practice Address - Fax:248-681-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIED008882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N99220Medicare PIN