Provider Demographics
NPI:1235213927
Name:PERLMUTTER, MARK ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:PERLMUTTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:210 LITTLE LAKE DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6218
Mailing Address - Country:US
Mailing Address - Phone:734-761-5908
Mailing Address - Fax:734-761-5928
Practice Address - Street 1:210 LITTLE LAKE DR
Practice Address - Street 2:SUITE 8
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6218
Practice Address - Country:US
Practice Address - Phone:734-761-5908
Practice Address - Fax:734-761-5928
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI2301007524111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor