=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467445775
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES KRAVIS, D.C., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2005
-----------------------------------------------------
Last Update Date | 08/12/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31395 W. 7 MILE RD. SUITE G
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48152-4335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-426-6600
-----------------------------------------------------
Fax | 248-426-6603
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31395 W. 7 MILE RD. SUITE G
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48152-4335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-426-6600
-----------------------------------------------------
Fax | 248-426-6603
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JAMES B KRAVIS
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 248-426-6600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2301300315
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------