Provider Demographics
NPI:1366032070
Name:NEW WAVE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:NEW WAVE CHIROPRACTIC PLLC
Other - Org Name:NEW WAVE CHIROPRACTIC PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:ZARNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:124-842-1808
Mailing Address - Street 1:12702 KING RD
Mailing Address - Street 2:
Mailing Address - City:THOMPSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49683-9344
Mailing Address - Country:US
Mailing Address - Phone:124-842-1808
Mailing Address - Fax:
Practice Address - Street 1:52 PALCICH RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:MI
Practice Address - Zip Code:49635-9602
Practice Address - Country:US
Practice Address - Phone:248-421-8082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty