Provider Demographics
NPI:1689976904
Name:RIFFEL CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:RIFFEL CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-752-5001
Mailing Address - Street 1:117 W SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-4655
Mailing Address - Country:US
Mailing Address - Phone:586-752-5001
Mailing Address - Fax:
Practice Address - Street 1:117 W SAINT CLAIR ST
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-4655
Practice Address - Country:US
Practice Address - Phone:586-752-5001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOEO5014Medicare PIN