MEDICARE: SYLVAN POINT WELLNESS PLLC

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

General Provider Information

NPI Number	:	1932585601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYLVAN POINT WELLNESS PLLC

Provider Business Mailing Address
First Line	:	2715 S LINCOLN RD
Second Line	:
City	:	ESCANABA
State	:	MI
Zip	:	49829-1066
Country	:	US
Telephone Number	:	906-786-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	26421 SOUTHFIELD RD
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-4528
Country	:	US
Telephone Number	:	248-905-5066
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JESSICA LEJA
Credential	:
Telephone Number	:	248-905-5066

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	08/05/2015

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Directions to “SYLVAN POINT WELLNESS PLLC ” Practice Location

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