Healthcare Provider Details

I. General information

NPI: 1639220767
Provider Name (Legal Business Name): STONE CHIROPRACTIC CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 MILLER RD STE 4
SWARTZ CREEK MI
48473-1115
US

IV. Provider business mailing address

9001 MILLER RD. STE 4
SWARTZ CREEK MI
48473-1115
US

V. Phone/Fax

Practice location:
  • Phone: 810-635-8428
  • Fax: 810-635-4626
Mailing address:
  • Phone: 810-635-8428
  • Fax: 810-635-4626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301003092
License Number StateMI

VIII. Authorized Official

Name: DR. DOUGLAS CORNELIUS STONE
Title or Position: OWNER
Credential: D.C.
Phone: 810-635-8428