Provider Demographics
NPI:1851797021
Name:APPLIED HEALTH CHIROPRACTIC CLINIC, PC
Entity Type:Organization
Organization Name:APPLIED HEALTH CHIROPRACTIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEFA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-513-1703
Mailing Address - Street 1:3302 PENCOMBE PL
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2351
Mailing Address - Country:US
Mailing Address - Phone:810-513-1703
Mailing Address - Fax:
Practice Address - Street 1:3302 PENCOMBE PL
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2351
Practice Address - Country:US
Practice Address - Phone:810-513-1703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty