Healthcare Provider Details

I. General information

NPI: 1679578710
Provider Name (Legal Business Name): JAMES P RIBLEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20960 TELEGRAPH RD
BROWNSTOWN MI
48174-9319
US

IV. Provider business mailing address

20960 TELEGRAPH RD
BROWNSTOWN MI
48174-9319
US

V. Phone/Fax

Practice location:
  • Phone: 734-479-2700
  • Fax: 734-479-5133
Mailing address:
  • Phone: 734-479-2700
  • Fax: 734-479-5133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301006165
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: