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General NPI Number Information
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NPI Number | 1801935770
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Entity Type | Organization
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Legal Business Name | PROHEALTH CHIROPRACTIC ASSOCIATES PC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 40552 LADENE LN
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City | NOVI
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State | MI
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Zip | 48375-5135
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Country | US
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Telephone | 248-974-2486
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Fax | 248-348-2308
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Provider Business Mailing Address
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Address Line | 40552 LADENE LN
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City | NOVI
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State | MI
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Zip | 48375-5135
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Country | US
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Telephone | 248-974-2486
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Fax | 248-348-2308
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Authorized Official
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Title or Position | CEO
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Name | DR. MARC S KRAMER
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Credential | D.C.
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Telephone | 248-974-2486
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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 | 2301009304
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License Number State | MI
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