MEDICARE: ROY CHIROPRACTIC CENTERS PLLC

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	2301009207	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2301009207	OTHER	MI	STATE LICENSE NUMBER
3	WP009063	OTHER	MI	COMMERCIAL
4	OF33423	OTHER	MI	BCBSM PIN
5	11611173	OTHER	MI	CAQH ID

General Provider Information

NPI Number	:	1588079065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROY CHIROPRACTIC CENTERS PLLC

Provider Business Mailing Address
First Line	:	115 E 3RD ST
Second Line	:
City	:	ROCHESTER
State	:	MI
Zip	:	48307-2011
Country	:	US
Telephone Number	:	248-923-2428
Fax Number	:	248-656-6958

Provider Business Practice Location Address
First Line	:	115 E 3RD ST
Second Line	:
City	:	ROCHESTER
State	:	MI
Zip	:	48307-2011
Country	:	US
Telephone Number	:	248-923-2428
Fax Number	:	248-656-6958

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARIE-CLAUDE ROY
Credential	:	D.C.
Telephone Number	:	248-923-2428

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	11/30/2020

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