Healthcare Provider Details

I. General information

NPI: 1053618645
Provider Name (Legal Business Name): DR DEANA LAJINESS DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 WALTON BLVD
ROCHESTER HILLS MI
48309-1419
US

IV. Provider business mailing address

2909 WALTON BLVD
ROCHESTER HILLS MI
48309-1419
US

V. Phone/Fax

Practice location:
  • Phone: 248-318-5005
  • Fax: 248-373-5865
Mailing address:
  • Phone: 248-318-5005
  • Fax: 248-373-5865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number2301009616
License Number StateMI

VIII. Authorized Official

Name: DR. DEANA LAJINESS
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 248-318-5005