Provider Demographics
NPI:1235209230
Name:JOHR FAMILY CHIROPRACTIC , PLLC
Entity Type:Organization
Organization Name:JOHR FAMILY CHIROPRACTIC , PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:JOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-601-8843
Mailing Address - Street 1:1460 WALTON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1768
Mailing Address - Country:US
Mailing Address - Phone:248-601-8843
Mailing Address - Fax:248-601-1824
Practice Address - Street 1:1460 WALTON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1768
Practice Address - Country:US
Practice Address - Phone:248-601-8843
Practice Address - Fax:248-601-1824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJJ007790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU79940Medicare UPIN
MI0M99520Medicare ID - Type Unspecified