Provider Demographics
NPI:1275361842
Name:SPRUCE CHIROPRACTIC
Entity type:Organization
Organization Name:SPRUCE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLESCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-660-8210
Mailing Address - Street 1:300 S RIVERSIDE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079-5386
Mailing Address - Country:US
Mailing Address - Phone:810-660-8210
Mailing Address - Fax:231-396-8108
Practice Address - Street 1:300 S RIVERSIDE AVE STE 104
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079-5386
Practice Address - Country:US
Practice Address - Phone:810-660-8210
Practice Address - Fax:231-396-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty