Healthcare Provider Details

I. General information

NPI: 1609290048
Provider Name (Legal Business Name): RYKSE CHIROPRACTIC AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 W NORTON AVE SUITE 1-D
NORTON SHORES MI
49441-4195
US

IV. Provider business mailing address

935 W NORTON AVE SUITE 1-D
NORTON SHORES MI
49441-4195
US

V. Phone/Fax

Practice location:
  • Phone: 734-652-3101
  • Fax:
Mailing address:
  • Phone: 734-652-3101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009807
License Number StateMI

VIII. Authorized Official

Name: DR. MICHAEL T RYKSE
Title or Position: OWNER/OPERATOR
Credential: D.C.
Phone: 734-652-3101