Provider Demographics
NPI:1679239784
Name:SONQUIST FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:SONQUIST FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SONQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-302-4116
Mailing Address - Street 1:3999 CENTERPOINT PKWY STE 111
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-3122
Mailing Address - Country:US
Mailing Address - Phone:248-302-4116
Mailing Address - Fax:
Practice Address - Street 1:3999 CENTERPOINT PKWY STE 111
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-3122
Practice Address - Country:US
Practice Address - Phone:248-302-4116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty