Provider Demographics
NPI:1316322571
Name:TEMPLE, RONALD (DC)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:TEMPLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26421 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4528
Mailing Address - Country:US
Mailing Address - Phone:248-905-5066
Mailing Address - Fax:
Practice Address - Street 1:646 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:BRONSON
Practice Address - State:MI
Practice Address - Zip Code:49028-1323
Practice Address - Country:US
Practice Address - Phone:517-369-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor