Healthcare Provider Details

I. General information

NPI: 1699882951
Provider Name (Legal Business Name): AHAD E LOTFI DC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60069 COUNTY ROAD 687
HARTFORD MI
49057-9601
US

IV. Provider business mailing address

60069 COUNTY ROAD 687
HARTFORD MI
49057-9601
US

V. Phone/Fax

Practice location:
  • Phone: 269-621-3800
  • Fax: 269-621-2556
Mailing address:
  • Phone: 269-621-3800
  • Fax: 269-621-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301006100
License Number StateMI

VIII. Authorized Official

Name: DR. AHAD E LOTFI
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 269-621-3800