Healthcare Provider Details

I. General information

NPI: 1215376231
Provider Name (Legal Business Name): ERIC MICHAEL ZATKIN D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25882 ORCHARD LAKE RD
FARMINGTON HILLS MI
48336-1292
US

IV. Provider business mailing address

25882 ORCHARD LAKE RD
FARMINGTON HILLS MI
48336-1292
US

V. Phone/Fax

Practice location:
  • Phone: 248-426-0022
  • Fax: 248-426-0044
Mailing address:
  • Phone: 248-426-0022
  • Fax: 248-426-0044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010100
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: