Provider Demographics
NPI:1023311628
Name:DR D F KOTSONIS PLLC
Entity type:Organization
Organization Name:DR D F KOTSONIS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:F
Authorized Official - Last Name:KOTSONIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-792-2300
Mailing Address - Street 1:35737 HARPER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-3210
Mailing Address - Country:US
Mailing Address - Phone:586-792-2300
Mailing Address - Fax:
Practice Address - Street 1:35737 HARPER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-3210
Practice Address - Country:US
Practice Address - Phone:586-792-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty