Healthcare Provider Details

I. General information

NPI: 1659562288
Provider Name (Legal Business Name): DR HANDLEY & ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 PICKFORD
SHELBY TWP MI
48316-4835
US

IV. Provider business mailing address

PO BOX 544
ROMEO MI
48065-0544
US

V. Phone/Fax

Practice location:
  • Phone: 586-232-3073
  • Fax:
Mailing address:
  • Phone: 586-232-3073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2301004854
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. CHESTER BURNIDGE HANDLEY
Title or Position: MANAGING DIRECTOR
Credential: M,D.,D.C.
Phone: 586-232-3073