Provider Demographics
NPI:1528589595
Name:PARKS CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:PARKS CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-242-6200
Mailing Address - Street 1:1058 N. MONROE STREET
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3374
Mailing Address - Country:US
Mailing Address - Phone:734-242-6200
Mailing Address - Fax:734-242-3441
Practice Address - Street 1:1058 N. MONROE STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3374
Practice Address - Country:US
Practice Address - Phone:734-242-6200
Practice Address - Fax:734-242-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty