Provider Demographics
NPI:1942771589
Name:RESTORATION CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:RESTORATION CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOCERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-596-2370
Mailing Address - Street 1:6825 HANNA LAKE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-9118
Mailing Address - Country:US
Mailing Address - Phone:586-596-2370
Mailing Address - Fax:989-548-6033
Practice Address - Street 1:6825 HANNA LAKE AVE SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-9118
Practice Address - Country:US
Practice Address - Phone:586-596-2370
Practice Address - Fax:989-548-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty