Provider Demographics
NPI:1497804165
Name:NEW HUDSON CHIROPRACTIC & WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:NEW HUDSON CHIROPRACTIC & WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-486-5684
Mailing Address - Street 1:P.O. BOX 315
Mailing Address - Street 2:30033 SHEFPO
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165
Mailing Address - Country:US
Mailing Address - Phone:248-486-5684
Mailing Address - Fax:248-486-5686
Practice Address - Street 1:30033 SHEFPO DRIVE
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165
Practice Address - Country:US
Practice Address - Phone:248-486-5684
Practice Address - Fax:248-486-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPR007680111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7211780OtherAETNA
MI950F328890OtherBLUE CROSS BLUE SHIELD
MINC008753OtherMCARE
MI7211780OtherAETNA
U77434Medicare UPIN