Provider Demographics
NPI:1063785855
Name:MYINT FAMILY CHIROPRACTIC, INC
Entity type:Organization
Organization Name:MYINT FAMILY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:MYINT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-323-7714
Mailing Address - Street 1:7200 DAN HOEY RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-4201
Mailing Address - Country:US
Mailing Address - Phone:734-323-7714
Mailing Address - Fax:
Practice Address - Street 1:7200 DAN HOEY RD
Practice Address - Street 2:SUITE F
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-4201
Practice Address - Country:US
Practice Address - Phone:734-323-7714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009617111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty