Provider Demographics
NPI:1467420794
Name:MIRAMONTI, FRANK C (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:C
Last Name:MIRAMONTI
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:DR
Other - First Name:F.
Other - Middle Name:CURT
Other - Last Name:MIRAMONTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC, CCSP
Mailing Address - Street 1:51 SOUTHBOUND GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2386
Mailing Address - Country:US
Mailing Address - Phone:586-465-5640
Mailing Address - Fax:586-465-2411
Practice Address - Street 1:51 SOUTHBOUND GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2386
Practice Address - Country:US
Practice Address - Phone:586-465-5640
Practice Address - Fax:586-465-2411
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-11
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIFM 005578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2833176Medicaid
MI2833176Medicaid
MI0E0 5262Medicare ID - Type Unspecified