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General NPI Number Information
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NPI Number | 1477878254
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Entity Type | Organization
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Legal Business Name | MEMPHIS FAMILY CHIROPRACTIC PLC
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 35040 HELZE LANE
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City | RICHMOND
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State | MI
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Zip | 48062
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Country | US
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Telephone | 810-392-7373
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Fax | 810-392-8331
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Provider Business Mailing Address
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Address Line | PO BOX 41037
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City | MEMPHIS
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State | MI
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Zip | 48041-1037
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Country | US
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Telephone | 810-392-7373
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Fax | 810-392-8331
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. NICOLA JAKSA
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Credential | DC
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Telephone | 810-392-7373
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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 |
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License Number State |
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