Provider Demographics
NPI:1336469139
Name:NEW ERA PT SERVICES
Entity Type:Organization
Organization Name:NEW ERA PT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GIGI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:248-233-0659
Mailing Address - Street 1:G4007 W COURT ST STE G2
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48437
Mailing Address - Country:US
Mailing Address - Phone:810-230-0444
Mailing Address - Fax:
Practice Address - Street 1:G4007 W COURT ST STE G2
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3560
Practice Address - Country:US
Practice Address - Phone:810-230-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty