Healthcare Provider Details

I. General information

NPI: 1225465495
Provider Name (Legal Business Name): INFINITY WELLNESS OF FLINT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2329 STONEBRIDGE DR BLDG E
FLINT MI
48532-5407
US

IV. Provider business mailing address

750 S OLD WOODWARD AVE
BIRMINGHAM MI
48009-6600
US

V. Phone/Fax

Practice location:
  • Phone: 810-471-4280
  • Fax: 810-355-2277
Mailing address:
  • Phone: 248-792-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SILVIO J COZZETTO
Title or Position: OWNER
Credential:
Phone: 248-792-6570