Provider Demographics
NPI:1134157068
Name:LABER, COREY JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:JAMES
Last Name:LABER
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 1:903 S LATSON RD
Mailing Address - Street 2:#244
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7595
Mailing Address - Country:US
Mailing Address - Phone:517-546-1281
Mailing Address - Fax:517-546-5003
Practice Address - Street 1:3473 E GRAND RIVER AVE
Practice Address - Street 2:STE. A
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-4512
Practice Address - Country:US
Practice Address - Phone:517-546-1281
Practice Address - Fax:517-546-5003
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION93960001Medicare PIN
MIU85093Medicare UPIN