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General NPI Number Information
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NPI Number | 1598030728
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Entity Type | Organization
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Legal Business Name | ROBERTS CHIROPRACTIC LIFE CENTER, PLLC
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 13301 REECK CT STE 1A
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City | SOUTHGATE
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State | MI
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Zip | 48195-3054
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Country | US
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Telephone | 734-282-8484
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Fax | 734-282-7295
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Provider Business Mailing Address
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Address Line | 13301 REECK CT STE 1A
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City | SOUTHGATE
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State | MI
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Zip | 48195-3054
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Country | US
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Telephone | 734-282-8484
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Fax | 734-282-7295
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBIN LEE ROBERTS
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Credential | D.C.
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Telephone | 734-282-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number |
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License Number State |
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Taxonomy #8
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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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