Provider Demographics
NPI:1972258762
Name:COLLECTIVE CULTURE HEALTH & CHIROPRACTIC
Entity Type:Organization
Organization Name:COLLECTIVE CULTURE HEALTH & CHIROPRACTIC
Other - Org Name:COLLECTIVE CULTURE HEALTH & CHIROPRACTIC PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIOLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-779-0188
Mailing Address - Street 1:2627 FLEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2035 HOGBACK RD STE 204
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9488
Practice Address - Country:US
Practice Address - Phone:734-330-2616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-20
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty