Provider Demographics
NPI:1225222730
Name:MICHIGAN SPINE & JOINT CENTER P.C.
Entity Type:Organization
Organization Name:MICHIGAN SPINE & JOINT CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-725-3100
Mailing Address - Street 1:32500 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-1991
Mailing Address - Country:US
Mailing Address - Phone:158-672-5310
Mailing Address - Fax:158-672-5315
Practice Address - Street 1:32500 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-1991
Practice Address - Country:US
Practice Address - Phone:158-672-5310
Practice Address - Fax:158-672-5315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P51700Medicare UPIN