Provider Demographics
NPI:1225217177
Name:LABER FAMILY CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:LABER FAMILY CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LABER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-546-1281
Mailing Address - Street 1:903 S LATSON RD
Mailing Address - Street 2:SUITE 244
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7595
Mailing Address - Country:US
Mailing Address - Phone:517-546-1281
Mailing Address - Fax:517-546-5003
Practice Address - Street 1:3473 E GRAND RIVER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-4512
Practice Address - Country:US
Practice Address - Phone:517-546-1281
Practice Address - Fax:517-546-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N93960Medicare PIN
MIU85093Medicare UPIN