Provider Demographics
NPI:1386618791
Name:SEMLOW, KENT LEE (DC)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:LEE
Last Name:SEMLOW
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 1:15373 HALL RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-3841
Mailing Address - Country:US
Mailing Address - Phone:586-247-7020
Mailing Address - Fax:586-247-7021
Practice Address - Street 1:15373 HALL RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-3841
Practice Address - Country:US
Practice Address - Phone:586-247-7020
Practice Address - Fax:586-247-7021
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKS300293111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P14560Medicare PIN
MIU26753Medicare UPIN