Provider Demographics
NPI:1316475502
Name:SANCTUARY CHIROPRACTIC AND WELLNESS CORPORATION
Entity type:Organization
Organization Name:SANCTUARY CHIROPRACTIC AND WELLNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:F
Authorized Official - Last Name:JARY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-421-7100
Mailing Address - Street 1:36616 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1127
Mailing Address - Country:US
Mailing Address - Phone:734-421-7100
Mailing Address - Fax:
Practice Address - Street 1:36616 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1127
Practice Address - Country:US
Practice Address - Phone:734-421-7100
Practice Address - Fax:734-421-7103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006988111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty