Healthcare Provider Details
I. General information
NPI: 1770080863
Provider Name (Legal Business Name): ACTIVE CHIROPRACTIC PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2018
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 N ANN ARBOR ST STE C
SALINE MI
48176-1196
US
IV. Provider business mailing address
401 N ANN ARBOR ST STE C
SALINE MI
48176-1196
US
V. Phone/Fax
- Phone: 734-787-5295
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SHEILA
HEFFRON-MCGREAL
Title or Position: OWNER
Credential: DC
Phone: 734-787-5295