Provider Demographics
NPI:1437501053
Name:VITALITY PRECISION CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:VITALITY PRECISION CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-266-0837
Mailing Address - Street 1:2614 S ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-5509
Mailing Address - Country:US
Mailing Address - Phone:248-897-0699
Mailing Address - Fax:248-897-0611
Practice Address - Street 1:2614 S ADAMS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-5509
Practice Address - Country:US
Practice Address - Phone:248-897-0699
Practice Address - Fax:248-897-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty