Healthcare Provider Details
I. General information
NPI: 1982936944
Provider Name (Legal Business Name): BRIGHTON CHIROPRACTIC PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2010
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8599 W GRAND RIVER AVE STE A
BRIGHTON MI
48116-2332
US
IV. Provider business mailing address
8599 W GRAND RIVER AVE STE A
BRIGHTON MI
48116-2332
US
V. Phone/Fax
- Phone: 810-229-4095
- Fax: 810-229-0768
- Phone: 810-229-4095
- Fax: 810-229-0768
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 005462 |
| License Number State | MI |
VIII. Authorized Official
Name:
STEVEN
A
TOWNSEND
Title or Position: OWNER
Credential: DC
Phone: 810-229-4095