Provider Demographics
NPI:1821637133
Name:JAMES J DWAN DC, PLLC
Entity Type:Organization
Organization Name:JAMES J DWAN DC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:DWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-342-3855
Mailing Address - Street 1:2151 E 14 MILE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-7260
Mailing Address - Country:US
Mailing Address - Phone:248-265-3330
Mailing Address - Fax:248-265-3331
Practice Address - Street 1:2151 E 14 MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7260
Practice Address - Country:US
Practice Address - Phone:248-265-3330
Practice Address - Fax:248-265-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty