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General NPI Number Information
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NPI Number | 1043752629
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Entity Type | Organization
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Legal Business Name | JWAD CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 11/14/2016
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 5378 W DOHERTY ST
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-2708
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Country | US
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Telephone | 248-885-1581
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Fax |
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Provider Business Mailing Address
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Address Line | 5378 W DOHERTY ST
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-2708
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Country | US
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Telephone | 248-885-1581
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN JWAD
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Credential | D.C.
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Telephone | 248-885-1581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301010442
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License Number State | MI
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