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General NPI Number Information
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NPI Number | 1063785855
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Entity Type | Organization
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Legal Business Name | MYINT FAMILY CHIROPRACTIC, INC
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Dates
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Enumeration Date | 02/09/2012
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 7200 DAN HOEY RD SUITE F
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City | DEXTER
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State | MI
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Zip | 48130-4201
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Country | US
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Telephone | 734-323-7714
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 DAN HOEY RD SUITE F
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City | DEXTER
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State | MI
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Zip | 48130-4201
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Country | US
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Telephone | 734-323-7714
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STACEY LYN MYINT
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Credential | D.C.
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Telephone | 734-323-7714
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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 | 2301009617
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License Number State | MI
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