Provider Demographics
NPI:1932848306
Name:EMBER CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:EMBER CHIROPRACTIC, PLLC
Other - Org Name:EMBER CHIROPRACTIC, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-434-7015
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48450-0226
Mailing Address - Country:US
Mailing Address - Phone:810-696-2022
Mailing Address - Fax:
Practice Address - Street 1:5482 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MI
Practice Address - Zip Code:48450-9402
Practice Address - Country:US
Practice Address - Phone:810-696-2022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1285239566OtherNPI