Provider Demographics
NPI:1225709439
Name:MERCADO, KRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 8TH ST APT 482
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-1478
Mailing Address - Country:US
Mailing Address - Phone:734-709-1168
Mailing Address - Fax:
Practice Address - Street 1:5958 N CANTON CENTER RD STE 300
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2766
Practice Address - Country:US
Practice Address - Phone:734-709-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301011157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor