Provider Demographics
NPI:1396388757
Name:SPINE, BODY AND MIND
Entity Type:Organization
Organization Name:SPINE, BODY AND MIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELONIE
Authorized Official - Middle Name:LIN
Authorized Official - Last Name:SCHOENHERR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-840-0389
Mailing Address - Street 1:6060 STONEY VIEW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-4970
Mailing Address - Country:US
Mailing Address - Phone:248-840-0389
Mailing Address - Fax:
Practice Address - Street 1:6060 STONEY VIEW DR STE 200
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316-4970
Practice Address - Country:US
Practice Address - Phone:248-840-0389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty