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General NPI Number Information
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NPI Number | 1942226659
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Entity Type | Organization
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Legal Business Name | DONATHAN FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 17533 FORT ST
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City | RIVERVIEW
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State | MI
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Zip | 48193-6630
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Country | US
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Telephone | 734-283-3200
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Fax | 734-283-5541
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Provider Business Mailing Address
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Address Line | 17533 FORT ST
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City | RIVERVIEW
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State | MI
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Zip | 48193-6630
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Country | US
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Telephone | 734-283-3200
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Fax | 734-283-5541
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | DR. KEVIN JAMES DONATHAN
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Credential | DC
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Telephone | 734-283-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 2301008033
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 2301007586
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License Number State | MI
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