Provider Demographics
NPI:1659608339
Name:SALOMON CHIROPRACTIC HEALTH CENTER PC
Entity Type:Organization
Organization Name:SALOMON CHIROPRACTIC HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:SALOMON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-557-1818
Mailing Address - Street 1:24777 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3065
Mailing Address - Country:US
Mailing Address - Phone:248-557-1818
Mailing Address - Fax:
Practice Address - Street 1:24777 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3065
Practice Address - Country:US
Practice Address - Phone:248-557-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISS006928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1669709333Medicaid
MIMI2538001Medicare PIN