Healthcare Provider Details
I. General information
NPI: 1891889077
Provider Name (Legal Business Name): RIBLEY CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
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
- Phone: 734-479-2700
- Fax: 734-479-5133
- Phone: 734-479-2700
- Fax: 734-479-5133
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
CHARLES
E
RIBLEY
Title or Position: OWNER/PRESIDENT
Credential: D.C.
Phone: 734-479-2700