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General NPI Number Information
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NPI Number | 1245425263
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Entity Type | Organization
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Legal Business Name | CORBIN CHIROPRACTIC, PC
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 5092 W VIENNA RD SUITE H
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City | CLIO
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State | MI
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Zip | 48420-2803
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Country | US
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Telephone | 810-686-3123
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Fax | 810-686-3124
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Provider Business Mailing Address
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Address Line | 5092 W VIENNA RD SUITE H
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City | CLIO
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State | MI
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Zip | 48420-2803
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Country | US
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Telephone | 810-686-3123
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Fax | 810-686-3124
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SUSAN LYNN CORBIN
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Credential | D.C.
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Telephone | 810-686-3123
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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 | 2301008926
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License Number State | MI
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