Healthcare Provider Details

I. General information

NPI: 1669716551
Provider Name (Legal Business Name): CHELSEA CHIROPRACTIC & FUNCTIONAL NEUROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W MIDDLE ST SUITE E
CHELSEA MI
48118-1293
US

IV. Provider business mailing address

20780 ISLAND LAKE RD
CHELSEA MI
48118-9584
US

V. Phone/Fax

Practice location:
  • Phone: 734-845-1080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number2301010030
License Number StateMI

VIII. Authorized Official

Name: DR. NATHAN DAVID KEISER
Title or Position: DIRECTOR OF FUNCTIONAL NEUROLOGY
Credential: D.C., D.A.C.N.B.
Phone: 734-845-1080