Provider Demographics
NPI:1114377439
Name:EWING, JEFFREY (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:EWING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5889 WHITMORE LAKE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1998
Mailing Address - Country:US
Mailing Address - Phone:810-227-7799
Mailing Address - Fax:810-227-8999
Practice Address - Street 1:5889 WHITMORE LAKE RD STE 3
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1998
Practice Address - Country:US
Practice Address - Phone:810-227-7799
Practice Address - Fax:810-227-8999
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor