Provider Demographics
NPI:1598786238
Name:WARNER CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:WARNER CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:734-847-1111
Mailing Address - Street 1:8941 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-1656
Mailing Address - Country:US
Mailing Address - Phone:734-847-1111
Mailing Address - Fax:734-847-3392
Practice Address - Street 1:8941 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-1656
Practice Address - Country:US
Practice Address - Phone:734-847-1111
Practice Address - Fax:734-847-3392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI002794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
02612OtherPARAMOUNT
MI2893156Medicaid
MI2893156Medicaid
T91725Medicare UPIN
MI2893156Medicaid