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General NPI Number Information
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NPI Number | 1346564192
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Entity Type | Organization
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Legal Business Name | DR RENEE M NOOMIE P C
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 1977 E WATTLES RD STE A
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City | TROY
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State | MI
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Zip | 48085-5047
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Country | US
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Telephone | 248-524-9100
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Fax | 248-524-0614
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Provider Business Mailing Address
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Address Line | 1977 E WATTLES RD STE A
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City | TROY
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State | MI
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Zip | 48085-5047
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Country | US
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Telephone | 248-524-9100
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Fax | 248-524-0614
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RENEE MARIE NOOMIE
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Credential | D C
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Telephone | 248-524-9100
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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 | 2301004983
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License Number State | MI
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