Provider Demographics
NPI:1275854606
Name:R.J. PICARD, D.C., P.C.
Entity Type:Organization
Organization Name:R.J. PICARD, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PICARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-726-9860
Mailing Address - Street 1:50258 VAN DYKE
Mailing Address - Street 2:SUITE E
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48317
Mailing Address - Country:US
Mailing Address - Phone:586-726-9860
Mailing Address - Fax:586-726-9537
Practice Address - Street 1:50258 VAN DYKE
Practice Address - Street 2:SUITE E
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317
Practice Address - Country:US
Practice Address - Phone:586-726-9860
Practice Address - Fax:586-726-9537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0E05209Medicare UPIN