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NPI Code Detail

MEDICARE: LUPO CHIROPRACTIC LIFE CENTER, P.C.

MEDICARE: LUPO CHIROPRACTIC LIFE CENTER, 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
1225700000XMassage TherapistMI
2225100000XPhysical TherapistMI
3111N00000XChiropractorMI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1950E001220OTHERMIBCBS MI

General Provider Information

NPI Number : 1750428058
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUPO CHIROPRACTIC LIFE CENTER, P.C.
Provider Business Mailing Address
First Line : 27850 GRATIOT AVE
Second Line :
City : ROSEVILLE
State : MI
Zip : 48066-4803
Country : US
Telephone Number : 586-772-5876
Fax Number : 586-772-1122
Provider Business Practice Location Address
First Line : 27850 GRATIOT AVE
Second Line :
City : ROSEVILLE
State : MI
Zip : 48066-4803
Country : US
Telephone Number : 586-772-5876
Fax Number : 586-772-1122
Authorized Official
Title or Position : OWNER
Name : DR. JOSEPH LUPO
Credential : D.C.
Telephone Number : 586-772-5876
Provider Enumeration Date : 01/30/2007
Last Update Date : 05/07/2014

Similar Medicare Providers

1790636504 — JENNA JEAN STEIN
Practice Location Address:
27850 GRATIOT AVE
ROSEVILLE, MI
48066-4803
Practice Phone: 586-772-5876
Practice Fax: 586-772-1122
1568479350 — DR. JESSICA DE MARIE LUPO D.C.
Practice Location Address:
27850 GRATIOT AVE
ROSEVILLE, MI
48066-4803
Practice Phone: 586-772-5876
Practice Fax: 586-772-1122
1851457139 — DR. JEFFREY JOSEPH LUPO D.C.
Practice Location Address:
27850 GRATIOT AVE
ROSEVILLE, MI
48066-4803
Practice Phone: 586-772-5876
Practice Fax: 586-772-1122
1821154113 — DR. JOSEPH LUPO D.C.
Practice Location Address:
27850 GRATIOT AVE
ROSEVILLE, MI
48066-4803
Practice Phone: 586-772-5876
Practice Fax: 586-772-1122
1568609246 — DR. SHAHID ALI KHAN D.C.
Practice Location Address:
27850 GRATIOT AVE
ROSEVILLE, MI
48066-4803
Practice Phone: 586-772-5876
Practice Fax: 586-772-1122
1205172038 — KENTON KYLE MAKI
Practice Location Address:
27850 GRATIOT AVE
ROSEVILLE, MI
48066-4803
Practice Phone: 586-772-5876
Practice Fax: 586-772-5876

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