Healthcare Provider Details

I. General information

NPI: 1225497795
Provider Name (Legal Business Name): CONFLITTI GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28107 JOHN R RD
MADISON HEIGHTS MI
48071-2810
US

IV. Provider business mailing address

28107 JOHN R RD
MADISON HEIGHTS MI
48071-2810
US

V. Phone/Fax

Practice location:
  • Phone: 248-542-3492
  • Fax: 248-542-3494
Mailing address:
  • Phone: 248-542-3492
  • Fax: 248-542-3494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN CONFLITTI
Title or Position: PRESIDENT
Credential: D.C.
Phone: 248-542-3492