Provider Demographics
NPI:1184818445
Name:ROBINSON CHIROPRACTIC & PERSONAL FITNESS CENTER PC
Entity Type:Organization
Organization Name:ROBINSON CHIROPRACTIC & PERSONAL FITNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-443-5545
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-1000
Mailing Address - Country:US
Mailing Address - Phone:248-443-5545
Mailing Address - Fax:248-443-5560
Practice Address - Street 1:23077 GREENFIELD RD
Practice Address - Street 2:SUITE 260
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3709
Practice Address - Country:US
Practice Address - Phone:248-443-5545
Practice Address - Fax:248-443-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4379382Medicaid
MI950F341760OtherBCBSM PIN
MI4379382Medicaid
MIU84477Medicare UPIN