Healthcare Provider Details

I. General information

NPI: 1609674654
Provider Name (Legal Business Name): MVMT GC P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28050 FORD RD STE A&B
GARDEN CITY MI
48135-2967
US

IV. Provider business mailing address

28050 FORD RD STE A&B
GARDEN CITY MI
48135-2967
US

V. Phone/Fax

Practice location:
  • Phone: 313-768-5385
  • Fax: 313-768-5387
Mailing address:
  • Phone: 313-768-5385
  • Fax: 313-768-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MUSTAFA RAYCHOUNI
Title or Position: OWNER
Credential: DC
Phone: 313-768-5385