Provider Demographics
NPI:1780985465
Name:BE WELL OF BIRMINGHAM PLLC
Entity type:Organization
Organization Name:BE WELL OF BIRMINGHAM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SILVIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:COZZETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-792-6570
Mailing Address - Street 1:750 S OLD WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6600
Mailing Address - Country:US
Mailing Address - Phone:248-792-6570
Mailing Address - Fax:248-792-6574
Practice Address - Street 1:750 S OLD WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6600
Practice Address - Country:US
Practice Address - Phone:248-792-6570
Practice Address - Fax:248-792-6574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty