Provider Demographics
NPI:1457525362
Name:ROCHESTER HILLS SPINE CARE PC
Entity Type:Organization
Organization Name:ROCHESTER HILLS SPINE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-303-4121
Mailing Address - Street 1:2565 S ROCHESTER RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4472
Mailing Address - Country:US
Mailing Address - Phone:586-299-8900
Mailing Address - Fax:586-299-8923
Practice Address - Street 1:2565 S ROCHESTER RD
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4472
Practice Address - Country:US
Practice Address - Phone:586-299-8900
Practice Address - Fax:586-299-8923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0H70797OtherBC
0H70797OtherBC