Healthcare Provider Details

I. General information

NPI: 1629467857
Provider Name (Legal Business Name): NICHOLAS ZYROWSKI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 21 MILE RD
MACOMB MI
48044-5024
US

IV. Provider business mailing address

15300 21 MILE RD
MACOMB MI
48044-5024
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-1376
  • Fax:
Mailing address:
  • Phone: 586-263-1376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010267
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: