Provider Demographics
NPI:1689059693
Name:PERKINS FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PERKINS FAMILY CHIROPRACTIC LLC
Other - Org Name:PERKINS FAMILY WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-478-6203
Mailing Address - Street 1:33966 W 8 MILE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48335-5273
Mailing Address - Country:US
Mailing Address - Phone:248-478-6203
Mailing Address - Fax:248-478-6205
Practice Address - Street 1:33966 W 8 MILE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48335-5273
Practice Address - Country:US
Practice Address - Phone:248-478-6203
Practice Address - Fax:248-478-6205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERKINS FAMILY CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-21
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP53870002Medicare UPIN