Provider Demographics
NPI:1497319172
Name:PALLADINELLI, NICHOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:PALLADINELLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:NICHOLAS
Other - Middle Name:
Other - Last Name:PALLADINELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:13718 STERLING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-4381
Mailing Address - Country:US
Mailing Address - Phone:586-615-4496
Mailing Address - Fax:
Practice Address - Street 1:44777 HAYES RD STE A
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1421
Practice Address - Country:US
Practice Address - Phone:586-209-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-27
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor