Healthcare Provider Details
I. General information
NPI: 1396949350
Provider Name (Legal Business Name): ZANONI CHIROPRACTIC CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2007
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
29050 HARPER AVE
SAINT CLAIR SHORES MI
48081-1200
US
IV. Provider business mailing address
22206 VISNAW ST
SAINT CLAIR SHORES MI
48081-1245
US
V. Phone/Fax
- Phone: 586-774-0091
- Fax:
- Phone: 586-206-1910
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | JZ007810 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
JOSEPH
M
ZANONI
Title or Position: PRESIDENT
Credential: DC
Phone: 586-774-0091