Provider Demographics
NPI:1891989869
Name:TODD ALLEN CAMARATA DC
Entity Type:Organization
Organization Name:TODD ALLEN CAMARATA DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CAMARATA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-939-0545
Mailing Address - Street 1:2743 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5962
Mailing Address - Country:US
Mailing Address - Phone:586-939-0545
Mailing Address - Fax:586-939-0546
Practice Address - Street 1:2743 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5962
Practice Address - Country:US
Practice Address - Phone:586-939-0545
Practice Address - Fax:586-939-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006654111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP03560001Medicare UPIN