Provider Demographics
NPI:1205068269
Name:HI-TEC TOTAL WELLNESS, PC
Entity type:Organization
Organization Name:HI-TEC TOTAL WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-478-0281
Mailing Address - Street 1:2645 BLUEWATER ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-1000
Mailing Address - Country:US
Mailing Address - Phone:734-478-0281
Mailing Address - Fax:866-611-1510
Practice Address - Street 1:2645 BLUEWATER ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-1000
Practice Address - Country:US
Practice Address - Phone:734-478-0281
Practice Address - Fax:866-611-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002789111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty