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General NPI Number Information
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NPI Number | 1528062080
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Entity Type | Individual
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Provider Name | JEFFREY CHARLES DUCHENE D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19199 15 MILE RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-2508
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Country | US
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Telephone | 586-791-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 19199 15 MILE RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-2508
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Country | US
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Telephone | 586-791-5555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | 2301005304
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License Number State | MI
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