Provider Demographics
NPI:1710907084
Name:ANN ARBOR CHIROPRACTIC WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:ANN ARBOR CHIROPRACTIC WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MEATH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-677-0600
Mailing Address - Street 1:2730 CARPENTER ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-0000
Mailing Address - Country:US
Mailing Address - Phone:734-677-0600
Mailing Address - Fax:734-677-0685
Practice Address - Street 1:2730 CARPENTER ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-0000
Practice Address - Country:US
Practice Address - Phone:734-677-0600
Practice Address - Fax:734-677-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty