Provider Demographics
NPI:1154441228
Name:LEVINE CHIROPRACTIC OF FARMINGTON HILLS P.C.
Entity Type:Organization
Organization Name:LEVINE CHIROPRACTIC OF FARMINGTON HILLS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-855-2666
Mailing Address - Street 1:31390 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE C.
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2561
Mailing Address - Country:US
Mailing Address - Phone:248-855-2666
Mailing Address - Fax:248-855-6460
Practice Address - Street 1:31390 NORTHWESTERN HWY
Practice Address - Street 2:SUITE C.
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2561
Practice Address - Country:US
Practice Address - Phone:248-855-2666
Practice Address - Fax:248-855-6460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI005201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F352350OtherBLUE CROSS PIN
MA950F326960OtherBLUE CROSS GROUP PIN
MI950F335790OtherBLUE CROSS PIN
MIT33412Medicare UPIN
MIU39892Medicare UPIN
MA950F326960OtherBLUE CROSS GROUP PIN