Provider Demographics
NPI:1689895039
Name:STONE CHIROPRACTIC HEALTH CENTER, PLLC
Entity Type:Organization
Organization Name:STONE CHIROPRACTIC HEALTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-654-0550
Mailing Address - Street 1:9126 LAPEER RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-3616
Mailing Address - Country:US
Mailing Address - Phone:810-654-0550
Mailing Address - Fax:810-654-0660
Practice Address - Street 1:9126 LAPEER RD
Practice Address - Street 2:SUITE 4
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-3616
Practice Address - Country:US
Practice Address - Phone:810-654-0550
Practice Address - Fax:810-654-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP23790Medicare ID - Type Unspecified