Provider Demographics
NPI:1467529453
Name:ARBOR WEST CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:ARBOR WEST CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TOBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-995-8770
Mailing Address - Street 1:2433 OAK VALLEY DR.
Mailing Address - Street 2:SUITE 600 B
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103
Mailing Address - Country:US
Mailing Address - Phone:734-995-8770
Mailing Address - Fax:734-995-7201
Practice Address - Street 1:2433 OAK VALLEY DR.
Practice Address - Street 2:SUITE 600 B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103
Practice Address - Country:US
Practice Address - Phone:734-995-8770
Practice Address - Fax:734-995-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMT005217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU38444Medicare UPIN
MI0H17636Medicare ID - Type Unspecified