Provider Demographics
NPI:1295832087
Name:ADVANCED HEALTH CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:ADVANCED HEALTH CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-813-0500
Mailing Address - Street 1:6585 ROCHESTER RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1363
Mailing Address - Country:US
Mailing Address - Phone:248-813-0500
Mailing Address - Fax:248-879-8055
Practice Address - Street 1:6585 ROCHESTER RD
Practice Address - Street 2:SUITE 107
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1363
Practice Address - Country:US
Practice Address - Phone:248-813-0500
Practice Address - Fax:248-879-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJB008436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherEIN
MI0P20010Medicare PIN