Healthcare Provider Details
I. General information
NPI: 1629124508
Provider Name (Legal Business Name): ALLAN N ZATKIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/25/2007
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25882 ORCHARD LAKE RD 205
FARMINGTON HILLS MI
48336-1292
US
IV. Provider business mailing address
25882 ORCHARD LAKE RD 205
FARMINGTON HILLS MI
48336-1292
US
V. Phone/Fax
- Phone: 248-426-0022
- Fax: 248-426-0044
- Phone: 248-426-0022
- Fax: 248-426-0044
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 004807 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: