Healthcare Provider Details

I. General information

NPI: 1780979062
Provider Name (Legal Business Name): UNITED WELLNESS CENTER OF DETROIT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19701 VERNIER RD SUITE 140
HARPER WOODS MI
48225-1467
US

IV. Provider business mailing address

19701 VERNIER RD SUITE 140
HARPER WOODS MI
48225-1467
US

V. Phone/Fax

Practice location:
  • Phone: 877-881-4696
  • Fax:
Mailing address:
  • Phone: 877-881-4696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELAINE CHEFAN
Title or Position: MANAGER
Credential:
Phone: 248-792-6570