Provider Demographics
NPI:1508096082
Name:MICHAELS, KEVIN H (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:H
Last Name:MICHAELS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 KENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1528
Mailing Address - Country:US
Mailing Address - Phone:248-881-0837
Mailing Address - Fax:313-873-0515
Practice Address - Street 1:2027 KENWOOD CT
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1528
Practice Address - Country:US
Practice Address - Phone:248-881-0837
Practice Address - Fax:313-873-0515
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor