Provider Demographics
NPI:1154758035
Name:BOOK FAMILY CHIROPRACTIC CLINC INC
Entity type:Organization
Organization Name:BOOK FAMILY CHIROPRACTIC CLINC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-529-3085
Mailing Address - Street 1:2301 S MILFORD RD STE A
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4985
Mailing Address - Country:US
Mailing Address - Phone:248-529-3085
Mailing Address - Fax:
Practice Address - Street 1:2301 S MILFORD RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4985
Practice Address - Country:US
Practice Address - Phone:248-529-3085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H70649OtherBBLUECROSSBLUESHIELD
MI0H70649OtherBBLUECROSSBLUESHIELD