Provider Demographics
NPI:1952530917
Name:TODD A. CAMARATA D.C., P.L.L.C.
Entity Type:Organization
Organization Name:TODD A. CAMARATA D.C., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CAMARATA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-246-8834
Mailing Address - Street 1:1977 E WATTLES RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5047
Mailing Address - Country:US
Mailing Address - Phone:586-246-8834
Mailing Address - Fax:248-524-0614
Practice Address - Street 1:1977 E WATTLES RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-5047
Practice Address - Country:US
Practice Address - Phone:586-246-8834
Practice Address - Fax:248-524-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty