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General NPI Number Information
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NPI Number | 1649033226
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Entity Type | Organization
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Legal Business Name | RESTORE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 801 W BIG BEAVER RD STE 300
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City | TROY
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State | MI
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Zip | 48084-4725
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Country | US
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Telephone | 248-933-3286
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Fax | 248-254-7462
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Provider Business Mailing Address
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Address Line | 801 W BIG BEAVER RD STE 300
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City | TROY
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State | MI
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Zip | 48084-4725
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Country | US
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Telephone | 248-933-3286
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Fax | 248-254-7462
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Authorized Official
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Title or Position | OWNER, DOCTOR OF CHIROPRACTIC
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Name | KEITH RANDALL DENNING
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Credential | DC
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Telephone | 248-933-3286
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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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