MEDICARE: SPINE, BODY AND MIND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1396388757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINE, BODY AND MIND

Provider Business Mailing Address
First Line	:	6060 STONEY VIEW DR STE 200
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4970
Country	:	US
Telephone Number	:	248-840-0389
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 STONEY VIEW DR STE 200
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4970
Country	:	US
Telephone Number	:	248-840-0389
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MELONIE LIN SCHOENHERR
Credential	:	DC
Telephone Number	:	248-840-0389

Provider Enumeration Date	:	10/17/2019
Last Update Date	:	10/17/2019

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Directions to “SPINE, BODY AND MIND ” Practice Location

Language	Start Address	Practice Location

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