Healthcare Provider Details

I. General information

NPI: 1396822623
Provider Name (Legal Business Name): PLENTZ CHIROPRACTIC CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9909 WAMPLERS LAKE RD
BROOKLYN MI
49230-9503
US

IV. Provider business mailing address

9909 WAMPLERS LAKE RD P.O. BOX 721
BROOKLYN MI
49230-9503
US

V. Phone/Fax

Practice location:
  • Phone: 517-592-8208
  • Fax: 517-592-4796
Mailing address:
  • Phone: 517-592-8208
  • Fax: 517-592-4796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT MANCHESTER
Title or Position: CO-OWNER
Credential: D.C
Phone: 517-592-8208