Provider Demographics
NPI:1164668851
Name:CARO CHIROPRACTIC CLINIC, PLLC
Entity Type:Organization
Organization Name:CARO CHIROPRACTIC CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:SALA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-673-5559
Mailing Address - Street 1:765 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1545
Mailing Address - Country:US
Mailing Address - Phone:989-673-5559
Mailing Address - Fax:
Practice Address - Street 1:765 N STATE ST
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-1545
Practice Address - Country:US
Practice Address - Phone:989-673-5559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty