Provider Demographics
NPI:1992016687
Name:DR. DAVID RIFFEL, CHIROPRACTOR, P.C.
Entity Type:Organization
Organization Name:DR. DAVID RIFFEL, CHIROPRACTOR, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:RIFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-792-1800
Mailing Address - Street 1:36620 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-1134
Mailing Address - Country:US
Mailing Address - Phone:586-792-1800
Mailing Address - Fax:586-792-0612
Practice Address - Street 1:36620 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-1134
Practice Address - Country:US
Practice Address - Phone:586-792-1800
Practice Address - Fax:586-792-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002367261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95-OEO5045OtherBLUE CROSS BLUE SHIELD MI
1154358927OtherNPI
MIP42810OtherBLUE CROSS BLUE SHIELD BLUE CARE NETWORK
OEO5045Medicare PIN
MI95-OEO5045OtherBLUE CROSS BLUE SHIELD MI