Provider Demographics
NPI:1831439058
Name:DR. ADAM N RUSHFORD DC PLLC
Entity type:Organization
Organization Name:DR. ADAM N RUSHFORD DC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:RUSHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-481-0064
Mailing Address - Street 1:10192 GRAND RIVER RD
Mailing Address - Street 2:SUITE 107A
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-6597
Mailing Address - Country:US
Mailing Address - Phone:678-481-0064
Mailing Address - Fax:248-573-7077
Practice Address - Street 1:10192 GRAND RIVER RD STE 107
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-6531
Practice Address - Country:US
Practice Address - Phone:810-494-1900
Practice Address - Fax:810-588-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty