Provider Demographics
NPI:1710090030
Name:HIMELHOCH, SHARON K (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:K
Last Name:HIMELHOCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4085 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-1957
Mailing Address - Country:US
Mailing Address - Phone:810-744-4251
Mailing Address - Fax:810-744-1039
Practice Address - Street 1:4085 S CENTER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519
Practice Address - Country:US
Practice Address - Phone:810-744-4251
Practice Address - Fax:810-744-1039
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0050461700OtherHEALTH PLUS
0B55193OtherBCBS
MI2991774Medicaid
P00098330OtherPALMETTO RAILROAD
P00098330OtherPALMETTO RAILROAD
0050461700OtherHEALTH PLUS