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General NPI Number Information
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NPI Number | 1134112386
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Entity Type | Organization
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Legal Business Name | ANCHOR CHIROPRACTIC PC
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32595 GRAND RIVER
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City | FARMINGTON
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State | MI
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Zip | 48336
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Country | US
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Telephone | 248-471-1250
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Fax | 248-471-0964
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Provider Business Mailing Address
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Address Line | 1945 TWIN SUN CIR
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City | WALLED LAKE
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State | MI
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Zip | 48390-4404
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Country | US
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Telephone | 248-960-1465
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Fax | 248-471-0964
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE MARITA FOXWORTHY
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Credential | DC
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Telephone | 248-471-1250
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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 | 2301004897
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License Number State | MI
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