Provider Demographics
NPI:1376553974
Name:WARNER, DENNIS ROBERT (BS DC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:ROBERT
Last Name:WARNER
Suffix:
Gender:M
Credentials:BS DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8941 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-1656
Mailing Address - Country:US
Mailing Address - Phone:734-847-1111
Mailing Address - Fax:734-847-3392
Practice Address - Street 1:8941 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-1656
Practice Address - Country:US
Practice Address - Phone:734-847-1111
Practice Address - Fax:734-847-3392
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI002794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382189181 00OtherBWC
02612OtherPARAMOUNT
MI2893156Medicaid
0E85022Medicare ID - Type Unspecified
02612OtherPARAMOUNT