Healthcare Provider Details

I. General information

NPI: 1952384661
Provider Name (Legal Business Name): GIULIO JAMES COGO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5889 WHITMORE LAKE RD SUITE C
BRIGHTON MI
48116-1998
US

IV. Provider business mailing address

5889 WHITMORE LAKE RD SUITE C
BRIGHTON MI
48116-1998
US

V. Phone/Fax

Practice location:
  • Phone: 810-227-7799
  • Fax: 810-227-8999
Mailing address:
  • Phone: 810-227-7799
  • Fax: 810-227-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberGC002816
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: