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General NPI Number Information
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NPI Number | 1124211933
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Entity Type | Organization
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Legal Business Name | SEMLOW CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 15373 HALL RD
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City | MACOMB
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State | MI
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Zip | 48044-3841
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Country | US
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Telephone | 586-247-7020
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Fax |
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Provider Business Mailing Address
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Address Line | 15373 HALL RD
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City | MACOMB
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State | MI
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Zip | 48044-3841
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Country | US
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Telephone | 586-247-7020
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. KENT SEMLOW
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Credential | D.C.
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Telephone | 586-247-7020
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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 | KS300293
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License Number State | MI
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