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General NPI Number Information
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NPI Number | 1033279427
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Entity Type | Organization
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Legal Business Name | ROYAL OAK CHIROPRACTIC CLINIC P C
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 28817 WOODWARD AVE STE 5
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City | BERKLEY
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State | MI
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Zip | 48072-0915
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Country | US
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Telephone | 248-544-2400
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Fax | 248-544-3079
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Provider Business Mailing Address
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Address Line | 1010 N CAMPBELL STE 5
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City | ROYAL OAK
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State | MI
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Zip | 48067
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Country | US
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Telephone | 248-544-2400
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Fax | 248-544-3079
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. HOWARD IRWIN MANELA
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Credential | DC
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Telephone | 248-544-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | HM005424
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License Number State | MI
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