Provider Demographics
NPI:1881949675
Name:ONE SOURCE HEALTH & SPINE INC
Entity type:Organization
Organization Name:ONE SOURCE HEALTH & SPINE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KARRUMI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-361-1465
Mailing Address - Street 1:2609 METROPOLITAN PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4216
Mailing Address - Country:US
Mailing Address - Phone:248-361-1465
Mailing Address - Fax:
Practice Address - Street 1:2609 METROPOLITAN PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4216
Practice Address - Country:US
Practice Address - Phone:248-361-1465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty