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General NPI Number Information
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NPI Number | 1104654581
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Entity Type | Organization
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Legal Business Name | ROOTED CHIROPRACTIC CANTON PLLC
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 1075 ANN ARBOR RD W
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City | PLYMOUTH
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State | MI
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Zip | 48170-2128
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Country | US
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Telephone | 734-455-3933
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Fax |
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Provider Business Mailing Address
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Address Line | 34730 PLYMOUTH RD
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City | LIVONIA
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State | MI
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Zip | 48150-1440
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | KATHERINE ROYEK
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Credential | DC
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Telephone | 734-455-3933
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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 |
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License Number State |
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