Provider Demographics
NPI:1891086047
Name:ANDRZEJAK FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:ANDRZEJAK FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDRZEJAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-635-5892
Mailing Address - Street 1:2847 ASHMUN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAULT STE. MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2847 ASHMUN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-3760
Practice Address - Country:US
Practice Address - Phone:906-635-5892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty