Provider Demographics
NPI:1801407580
Name:EMBRACE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:EMBRACE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-709-8649
Mailing Address - Street 1:6290 JUPITER AVE NE STE D
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49306-8885
Mailing Address - Country:US
Mailing Address - Phone:616-288-7165
Mailing Address - Fax:
Practice Address - Street 1:6290 JUPITER AVE NE STE D
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MI
Practice Address - Zip Code:49306-8885
Practice Address - Country:US
Practice Address - Phone:616-288-7165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty