Healthcare Provider Details

I. General information

NPI: 1174725287
Provider Name (Legal Business Name): VARGA FAMILY CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35000 DIVISION RD SUITE 7
RICHMOND MI
48062-1566
US

IV. Provider business mailing address

35000 DIVISION RD SUITE 7
RICHMOND MI
48062-1566
US

V. Phone/Fax

Practice location:
  • Phone: 586-727-8900
  • Fax: 586-727-3300
Mailing address:
  • Phone: 586-727-8900
  • Fax: 586-727-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number950E019860
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number950E021250
License Number StateMI

VIII. Authorized Official

Name: DR. LAURA JEAN VARGA
Title or Position: MEMBER
Credential: D.C.
Phone: 586-727-8900