Provider Demographics
NPI:1255689782
Name:POINTES CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:POINTES CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ZOUZAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:313-885-3500
Mailing Address - Street 1:15761 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-3479
Mailing Address - Country:US
Mailing Address - Phone:313-885-3500
Mailing Address - Fax:
Practice Address - Street 1:15761 MACK AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-3479
Practice Address - Country:US
Practice Address - Phone:313-885-3500
Practice Address - Fax:313-885-3843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004344111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Q25091Medicare PIN