Provider Demographics
NPI:1891980629
Name:MIARITIS, MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:MIARITIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40760 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-2534
Mailing Address - Country:US
Mailing Address - Phone:586-416-1180
Mailing Address - Fax:586-416-1192
Practice Address - Street 1:40760 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-2534
Practice Address - Country:US
Practice Address - Phone:586-416-1180
Practice Address - Fax:586-416-1192
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMM008687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor