Provider Demographics
NPI:1588545065
Name:DOWNRIVER SPINE MANAGEMENT CLINIC P.L.L.C
Entity type:Organization
Organization Name:DOWNRIVER SPINE MANAGEMENT CLINIC P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYCHOUNI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:313-768-5385
Mailing Address - Street 1:4828 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2914
Mailing Address - Country:US
Mailing Address - Phone:313-768-5385
Mailing Address - Fax:313-768-5387
Practice Address - Street 1:4828 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2914
Practice Address - Country:US
Practice Address - Phone:313-768-5385
Practice Address - Fax:313-768-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty