MEDICARE: DR. SUSAN K DORGAI D.C.

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	2301008577	MI

General Provider Information

NPI Number	:	1588707145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN K DORGAI D.C.

Provider Business Mailing Address
First Line	:	3215 STILLWAGON RD
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-9648
Country	:	US
Telephone Number	:	989-343-1425
Fax Number	:

Provider Business Practice Location Address
First Line	:	7887 COOLEY LAKE RD STE 102
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48324-3531
Country	:	US
Telephone Number	:	248-366-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	06/18/2013

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