Provider Demographics
NPI:1851659320
Name:KOR CHIRO STUDIO PLLC
Entity Type:Organization
Organization Name:KOR CHIRO STUDIO PLLC
Other - Org Name:KOR CHIRO STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SKALNICAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-360-0338
Mailing Address - Street 1:455 E GRAND RIVER AVE # 204
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1551
Mailing Address - Country:US
Mailing Address - Phone:810-360-0338
Mailing Address - Fax:810-355-2600
Practice Address - Street 1:455 E GRAND RIVER AVE # 204
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1551
Practice Address - Country:US
Practice Address - Phone:810-360-0338
Practice Address - Fax:810-355-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty