Provider Demographics
NPI:1154817088
Name:NEW HORIZON CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:NEW HORIZON CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:BOWEN
Authorized Official - Last Name:GOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-809-2072
Mailing Address - Street 1:15565 NORTHLAND DR W STE 308
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5312
Mailing Address - Country:US
Mailing Address - Phone:248-809-2072
Mailing Address - Fax:248-996-8457
Practice Address - Street 1:15565 NORTHLAND DR W STE 308
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5312
Practice Address - Country:US
Practice Address - Phone:248-809-2072
Practice Address - Fax:248-996-8457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)