Healthcare Provider Details

I. General information

NPI: 1326698655
Provider Name (Legal Business Name): CORY T BORAWSKI D.C. ( CHIROPRACTIC)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 N LEROY ST STE F
FENTON MI
48430-2795
US

IV. Provider business mailing address

1537 N LEROY ST STE F
FENTON MI
48430-2795
US

V. Phone/Fax

Practice location:
  • Phone: 810-629-6500
  • Fax: 810-629-6616
Mailing address:
  • Phone: 810-629-6500
  • Fax: 810-629-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010861
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: