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General NPI Number Information
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NPI Number | 1790968782
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Entity Type | Organization
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Legal Business Name | ADVANCED CHIROPRACTIC WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 3146 FRANCIS ST
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City | JACKSON
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State | MI
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Zip | 49203-5047
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Country | US
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Telephone | 517-784-3388
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Fax | 517-784-3305
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Provider Business Mailing Address
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Address Line | 33026 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-3075
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Country | US
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Telephone | 734-266-8444
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Fax | 734-266-8484
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Authorized Official
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Title or Position | DOCTOR/ OWNER
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Name | DR. ROBERT ANGELO DOTTO
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Credential | D.C.
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Telephone | 517-784-3388
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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 | 2301008733
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License Number State | MI
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