Provider Demographics
NPI:1871822650
Name:ELIZABETH, PLLC
Entity Type:Organization
Organization Name:ELIZABETH, PLLC
Other - Org Name:CORNERSTONE CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-329-9900
Mailing Address - Street 1:1820 SINCLAIR ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079-5905
Mailing Address - Country:US
Mailing Address - Phone:810-329-9900
Mailing Address - Fax:810-329-0900
Practice Address - Street 1:1820 SINCLAIR ST
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079-5905
Practice Address - Country:US
Practice Address - Phone:810-329-9900
Practice Address - Fax:810-329-0900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIEB006923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty