Provider Demographics
NPI:1528153764
Name:ODETTE CHIROPRACTIC FAMILY HEALTH CENTER PLC
Entity type:Organization
Organization Name:ODETTE CHIROPRACTIC FAMILY HEALTH CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-479-5130
Mailing Address - Street 1:20960 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1018
Mailing Address - Country:US
Mailing Address - Phone:734-479-5130
Mailing Address - Fax:734-479-4678
Practice Address - Street 1:20960 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1018
Practice Address - Country:US
Practice Address - Phone:734-479-5130
Practice Address - Fax:734-479-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty