Provider Demographics
NPI:1942494117
Name:KAMINSKI, RAYMOND J (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:J
Last Name:KAMINSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10575 MORANG DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-1880
Mailing Address - Country:US
Mailing Address - Phone:313-884-5477
Mailing Address - Fax:313-884-5478
Practice Address - Street 1:10575 MORANG DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-1880
Practice Address - Country:US
Practice Address - Phone:313-884-5477
Practice Address - Fax:313-884-5478
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRK003072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor