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General NPI Number Information
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NPI Number | 1255445540
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Entity Type | Organization
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Legal Business Name | TANNENBAUM CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 4059 STONE SCHOOL RD
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City | ANN ARBOR
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State | MI
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Zip | 48108
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Country | US
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Telephone | 734-929-0444
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Fax | 734-929-0350
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Provider Business Mailing Address
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Address Line | 4059 STONE SCHOOL RD
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City | ANN ARBOR
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State | MI
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Zip | 48108
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Country | US
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Telephone | 734-929-0444
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Fax | 734-929-0350
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Authorized Official
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Title or Position | OWNER CHIROPRACTOR
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Name | DR. MICHAEL GEORGE TANNENBAUM
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Credential | DC
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Telephone | 734-929-0444
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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 | 2301008615
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License Number State | MI
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