Provider Demographics
NPI:1619171592
Name:ARTHUR NIEDERKOHR DC LLC
Entity Type:Organization
Organization Name:ARTHUR NIEDERKOHR DC LLC
Other - Org Name:ANCHOR BAY SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NIEDERKOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-716-8493
Mailing Address - Street 1:51145 WASHINGTON ST
Mailing Address - Street 2:STE. E
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2100
Mailing Address - Country:US
Mailing Address - Phone:586-716-8493
Mailing Address - Fax:586-716-8493
Practice Address - Street 1:51145 WASHINGTON ST
Practice Address - Street 2:STE. E
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-2100
Practice Address - Country:US
Practice Address - Phone:586-716-8493
Practice Address - Fax:586-716-8493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty