Provider Demographics
NPI:1689863334
Name:WESTCOTT CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:WESTCOTT CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WESTCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-427-1579
Mailing Address - Street 1:29701 6 MILE RD STE 150A
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-8604
Mailing Address - Country:US
Mailing Address - Phone:734-427-1579
Mailing Address - Fax:734-427-0976
Practice Address - Street 1:29701 6 MILE RD STE 150A
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-8604
Practice Address - Country:US
Practice Address - Phone:734-427-1579
Practice Address - Fax:734-427-0976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJW007223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95-0-H2-3109-0OtherBLUE CROSS BLUE SHIELD
MICODRHMedicare UPIN
MIOM27940Medicare PIN