Healthcare Provider Details

I. General information

NPI: 1437425410
Provider Name (Legal Business Name): CAREY CHIROPRACTIC LIFE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2012
Last Update Date: 03/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4671 WASHTENAW AVE
ANN ARBOR MI
48108-1301
US

IV. Provider business mailing address

4671 WASHTENAW AVE
ANN ARBOR MI
48108-1301
US

V. Phone/Fax

Practice location:
  • Phone: 734-377-5659
  • Fax:
Mailing address:
  • Phone: 734-377-5659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009551
License Number StateMI

VIII. Authorized Official

Name: SCOTT ALLEN CAREY
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 734-377-5659