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General NPI Number Information
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NPI Number | 1790421261
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Entity Type | Organization
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Legal Business Name | SIMPLY WELL CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 37657 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-1543
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Country | US
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Telephone | 734-658-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 38113 LANCASTER ST
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City | LIVONIA
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State | MI
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Zip | 48154-1509
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Country | US
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Telephone | 734-658-7522
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAUNAH BUSCHBACHER
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Credential | DC
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Telephone | 734-658-7522
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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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