MEDICARE: MICHIGAN CHIROPRACTIC SPECIALISTS OF WATERFORD, P.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
1	111N00000X	Chiropractor	2301008114	MI

General Provider Information

NPI Number	:	1740336767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN CHIROPRACTIC SPECIALISTS OF WATERFORD, P.C.

Provider Business Mailing Address
First Line	:	1348 SCOTT LAKE RD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48328-1578
Country	:	US
Telephone Number	:	248-706-3428
Fax Number	:	248-706-3437

Provider Business Practice Location Address
First Line	:	1348 SCOTT LAKE RD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48328-1578
Country	:	US
Telephone Number	:	248-706-3428
Fax Number	:	248-706-3437

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ADAM JASON APFELBLAT
Credential	:	D.C.
Telephone Number	:	248-706-3428

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/22/2020

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