Healthcare Provider Details

I. General information

NPI: 1710693692
Provider Name (Legal Business Name): LINT CHIROPRACTIC II PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24901 NORTHWESTERN HWY STE 310
SOUTHFIELD MI
48075-2207
US

IV. Provider business mailing address

PO BOX 772813
DETROIT MI
48277-2813
US

V. Phone/Fax

Practice location:
  • Phone: 248-327-7550
  • Fax: 727-821-8913
Mailing address:
  • Phone: 877-401-1440
  • Fax: 727-821-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CANDICE KAYAL
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 734-536-8434