Healthcare Provider Details

I. General information

NPI: 1144144379
Provider Name (Legal Business Name): TROY CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E LONG LAKE RD STE 101
TROY MI
48085-4974
US

IV. Provider business mailing address

1120 E LONG LAKE RD STE 101
TROY MI
48085-4974
US

V. Phone/Fax

Practice location:
  • Phone: 248-300-5012
  • Fax:
Mailing address:
  • Phone: 248-300-5012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: SCOTT WITINKO
Title or Position: DC
Credential: DC
Phone: 248-300-5012