Provider Demographics
NPI:1881194579
Name:NOVI HOLISTIC HEALTH
Entity Type:Organization
Organization Name:NOVI HOLISTIC HEALTH
Other - Org Name:RENEW CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:STALMACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-878-3113
Mailing Address - Street 1:422 S DEXTER ST
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-9070
Mailing Address - Country:US
Mailing Address - Phone:734-878-3113
Mailing Address - Fax:
Practice Address - Street 1:422 S DEXTER ST
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-9070
Practice Address - Country:US
Practice Address - Phone:734-878-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-19
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009946111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty