Healthcare Provider Details

I. General information

NPI: 1518084292
Provider Name (Legal Business Name): HEALTHZONE CHIROPRACTIC II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E MAIN ST
NILES MI
49120-2200
US

IV. Provider business mailing address

70 E MAIN ST
NILES MI
49120-2200
US

V. Phone/Fax

Practice location:
  • Phone: 269-684-6354
  • Fax: 269-684-6403
Mailing address:
  • Phone: 269-684-6354
  • Fax: 269-684-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NT0100X
TaxonomyThermography Chiropractor
License Number008877
License Number StateMI

VIII. Authorized Official

Name: DR. WILLIAM VIRGIL ROBINSON III
Title or Position: CLINIC DIRECTOR
Credential: D.C.
Phone: 269-684-6354