Provider Demographics
NPI:1689790149
Name:DIMOVSKI CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:DIMOVSKI CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NEBOJSA
Authorized Official - Middle Name:NICK
Authorized Official - Last Name:DIMOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-880-2033
Mailing Address - Street 1:8023 GRAND RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9392
Mailing Address - Country:US
Mailing Address - Phone:810-229-4179
Mailing Address - Fax:810-229-4177
Practice Address - Street 1:8023 GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9392
Practice Address - Country:US
Practice Address - Phone:810-229-4179
Practice Address - Fax:810-229-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4720897Medicaid
MIU95295Medicare UPIN