Healthcare Provider Details

I. General information

NPI: 1659325009
Provider Name (Legal Business Name): INNERLINK CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28345 BECK RD SUITE 412
WIXOM MI
48393-4733
US

IV. Provider business mailing address

28345 BECK RD SUITE 412
WIXOM MI
48393-4733
US

V. Phone/Fax

Practice location:
  • Phone: 248-349-0300
  • Fax: 248-349-0307
Mailing address:
  • Phone: 248-349-0300
  • Fax: 248-349-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number2301008931
License Number StateMI

VIII. Authorized Official

Name: DR. CHRIS NIEDZINSKI
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 248-349-0300