Provider Demographics
NPI:1750674750
Name:4 CITIES FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:4 CITIES FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROVIDER/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:LIBERTY
Authorized Official - Last Name:SPIERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC FAAIM
Authorized Official - Phone:734-568-6066
Mailing Address - Street 1:3405 STERNS RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9576
Mailing Address - Country:US
Mailing Address - Phone:734-568-6066
Mailing Address - Fax:866-756-3721
Practice Address - Street 1:3405 STERNS RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9576
Practice Address - Country:US
Practice Address - Phone:734-568-6066
Practice Address - Fax:866-756-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301000459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2470400Medicaid
OH4123541Medicare PIN