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General NPI Number Information
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NPI Number | 1124185715
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Entity Type | Organization
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Legal Business Name | ETLINGER CHIROPRACTIC CLINIC PC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3601 WEST RD
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City | TRENTON
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State | MI
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Zip | 48183
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Country | US
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Telephone | 734-671-1400
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Fax | 734-671-0603
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Provider Business Mailing Address
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Address Line | 3601 WEST RD
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City | TRENTON
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State | MI
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Zip | 48183
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Country | US
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Telephone | 734-671-1400
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Fax | 734-671-0603
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Authorized Official
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Title or Position | PRESIDENT CHIROPRACTOR
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Name | DR. MICHAEL THOMAS ETLINGER
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Credential | DC
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Telephone | 734-671-1400
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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 | 2301004570
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License Number State | MI
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