Provider Demographics
NPI:1659761930
Name:FOUNDATION CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:FOUNDATION CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:SIMKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:313-930-3187
Mailing Address - Street 1:2749 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2427
Mailing Address - Country:US
Mailing Address - Phone:734-418-8177
Mailing Address - Fax:
Practice Address - Street 1:2749 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2427
Practice Address - Country:US
Practice Address - Phone:734-418-8177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010240111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty