Provider Demographics
NPI:1811061245
Name:COTTEN CHIROPRACTIC CENTER PLLC
Entity type:Organization
Organization Name:COTTEN CHIROPRACTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:VALDES
Authorized Official - Last Name:COTTEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:248-669-8080
Mailing Address - Street 1:1001 WELCH RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-2864
Mailing Address - Country:US
Mailing Address - Phone:248-669-8080
Mailing Address - Fax:248-669-8081
Practice Address - Street 1:1001 WELCH RD
Practice Address - Street 2:SUITE 111
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-2864
Practice Address - Country:US
Practice Address - Phone:248-669-8080
Practice Address - Fax:248-669-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINC005713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF353370Medicare ID - Type Unspecified