Healthcare Provider Details

I. General information

NPI: 1699862359
Provider Name (Legal Business Name): SILBERT CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13700 FORT ST
SOUTHGATE MI
48195-1153
US

IV. Provider business mailing address

13700 FORT ST
SOUTHGATE MI
48195-1153
US

V. Phone/Fax

Practice location:
  • Phone: 734-285-0020
  • Fax: 734-285-0512
Mailing address:
  • Phone: 734-285-0020
  • Fax: 734-285-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301005473
License Number StateMI

VIII. Authorized Official

Name: DR. DAVID SILBERT
Title or Position: PRESIDENT
Credential: D.C.
Phone: 734-285-0020