Provider Demographics
NPI:1316035124
Name:CHIROPRACTIC NATURAL HEALTH CENTER, P.C.
Entity Type:Organization
Organization Name:CHIROPRACTIC NATURAL HEALTH CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GIZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-650-1998
Mailing Address - Street 1:530 PINE ST
Mailing Address - Street 2:SUITE 2 AND 3
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1482
Mailing Address - Country:US
Mailing Address - Phone:248-650-1998
Mailing Address - Fax:248-650-3114
Practice Address - Street 1:530 PINE ST
Practice Address - Street 2:SUITE 2 AND 3
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1482
Practice Address - Country:US
Practice Address - Phone:248-650-1998
Practice Address - Fax:248-650-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU46756Medicare ID - Type Unspecified
MIU46756Medicare UPIN