Healthcare Provider Details

I. General information

NPI: 1730144643
Provider Name (Legal Business Name): BRUCE STANLEY ZAPOR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10415 GRAND RIVER RD SUITE 450
BRIGHTON MI
48116-6533
US

IV. Provider business mailing address

10415 GRAND RIVER RD SUITE 450
BRIGHTON MI
48116-6533
US

V. Phone/Fax

Practice location:
  • Phone: 810-229-1944
  • Fax: 810-229-6955
Mailing address:
  • Phone: 810-229-1944
  • Fax: 810-229-6955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberBZ006499
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: