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General NPI Number Information
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NPI Number | 1225281652
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Entity Type | Organization
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Legal Business Name | CHESTERFIELD FAMILY CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 06/24/2020
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Provider Practice Location Address
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Address Line | 28039 CARRIAGE WAY DR
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City | CHESTERFIELD
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State | MI
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Zip | 48051-2101
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Country | US
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Telephone | 586-948-7246
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Fax | 586-948-2748
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Provider Business Mailing Address
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Address Line | PO BOX 1171
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City | WALLED LAKE
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State | MI
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Zip | 48390-5171
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Country | US
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Telephone | 586-948-7246
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Fax | 586-948-2748
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TODD K KLEINSTEIN
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Credential | DC
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Telephone | 586-948-7246
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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 | 2301007789
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License Number State | MI
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