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General NPI Number Information
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NPI Number | 1154504694
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Entity Type | Organization
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Legal Business Name | COMMUNITY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 5901 W VERNOR HWY
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City | DETROIT
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State | MI
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Zip | 48209-2180
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Country | US
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Telephone | 313-554-4357
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Fax | 313-554-1565
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Provider Business Mailing Address
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Address Line | 5901 W VERNOR HWY
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City | DETROIT
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State | MI
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Zip | 48209-2180
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Country | US
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Telephone | 313-554-4357
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Fax | 313-554-1565
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RASHAD SALEH
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Credential | DC
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Telephone | 313-574-1191
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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 | 23010008454
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License Number State | MI
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