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General NPI Number Information
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NPI Number | 1184298853
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Entity Type | Organization
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Legal Business Name | DIMARTINO LIVONIA PC
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 31395 7 MILE RD STE G
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City | LIVONIA
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State | MI
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Zip | 48152-4335
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Country | US
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Telephone | 586-557-2614
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Fax |
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Provider Business Mailing Address
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Address Line | 30120 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-2190
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Country | US
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Telephone | 586-949-9248
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC DIMARTINO
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Credential | DC
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Telephone | 586-557-2614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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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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