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General NPI Number Information
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NPI Number | 1285852301
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Entity Type | Organization
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Legal Business Name | RAUCH CHIROPRACTIC LIFE CENTER
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 38904 DEQUINDRE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-2890
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Country | US
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Telephone | 586-978-8240
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Fax | 586-978-1417
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Provider Business Mailing Address
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Address Line | 38904 DEQUINDRE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-2890
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Country | US
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Telephone | 586-978-8240
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Fax | 586-978-1417
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY KARL RAUCH
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Credential | D.C.
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Telephone | 586-978-8240
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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 | 004112
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License Number State | MI
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