Provider Demographics
NPI:1790731289
Name:JEREMIAH M. SHAFT D.C. P.L.L.C.
Entity Type:Organization
Organization Name:JEREMIAH M. SHAFT D.C. P.L.L.C.
Other - Org Name:TRUE HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-231-9650
Mailing Address - Street 1:PO BOX 74126
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-0126
Mailing Address - Country:US
Mailing Address - Phone:734-941-2211
Mailing Address - Fax:734-941-2466
Practice Address - Street 1:9340 WAYNE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-1569
Practice Address - Country:US
Practice Address - Phone:734-941-2211
Practice Address - Fax:734-941-2466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty