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NPI Code Detail

MEDICARE: DR. ERICA LYNN SELBY- COOK D.C.

MEDICARE: DR. ERICA LYNN SELBY- COOK D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2301009258MI

General Provider Information

NPI Number : 1679656060
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERICA LYNN SELBY- COOK D.C.
Provider Business Mailing Address
First Line : 32500 23 MILE RD
Second Line :
City : CHESTERFIELD
State : MI
Zip : 48047-1991
Country : US
Telephone Number : 586-725-3100
Fax Number : 586-725-3155
Provider Business Practice Location Address
First Line : 57911 VAN DYKE RD
Second Line :
City : WASHINGTON
State : MI
Zip : 48094-2763
Country : US
Telephone Number : 586-228-0270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 11/22/2016

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