Provider Demographics
NPI:1275610966
Name:DIMARTINO CHIROPRACTIC CENTER, PC
Entity Type:Organization
Organization Name:DIMARTINO CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DIMARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-949-9248
Mailing Address - Street 1:30120 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2190
Mailing Address - Country:US
Mailing Address - Phone:586-949-9248
Mailing Address - Fax:586-949-6048
Practice Address - Street 1:30120 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-2190
Practice Address - Country:US
Practice Address - Phone:586-949-9248
Practice Address - Fax:586-949-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty