Healthcare Provider Details

I. General information

NPI: 1891989869
Provider Name (Legal Business Name): TODD ALLEN CAMARATA DC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 08/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2743 E 14 MILE RD
STERLING HEIGHTS MI
48310-5962
US

IV. Provider business mailing address

2743 E 14 MILE RD
STERLING HEIGHTS MI
48310-5962
US

V. Phone/Fax

Practice location:
  • Phone: 586-939-0545
  • Fax: 586-939-0546
Mailing address:
  • Phone: 586-939-0545
  • Fax: 586-939-0546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2301006654
License Number StateMI

VIII. Authorized Official

Name: TODD ALLEN CAMARATA
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 586-939-0545