Healthcare Provider Details

I. General information

NPI: 1730326885
Provider Name (Legal Business Name): STAR CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2009
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 6TH ST STE B
ROCHESTER MI
48307-1456
US

IV. Provider business mailing address

407 6TH ST STE B
ROCHESTER MI
48307-1456
US

V. Phone/Fax

Practice location:
  • Phone: 586-207-1702
  • Fax:
Mailing address:
  • Phone: 586-207-1702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number2301009309
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM RYAN MANDZIUK
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 586-207-1702