Healthcare Provider Details

I. General information

NPI: 1588739189
Provider Name (Legal Business Name): SANFORD CHIROPRACTIC CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 W SAGINAW RD
SANFORD MI
48657-9689
US

IV. Provider business mailing address

328 W SAGINAW RD PO BOX 469
SANFORD MI
48657-9689
US

V. Phone/Fax

Practice location:
  • Phone: 989-687-7376
  • Fax: 989-687-9584
Mailing address:
  • Phone: 989-687-7376
  • Fax: 989-687-9584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT THOMAS SMITH
Title or Position: OWNER
Credential: DC
Phone: 989-687-7376