Provider Demographics
NPI:1588949853
Name:ADVANCED FAMILY HEALTH.COM LLC
Entity type:Organization
Organization Name:ADVANCED FAMILY HEALTH.COM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:NOWICKI
Authorized Official - Last Name:AKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:1800-528-4223
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-0096
Mailing Address - Country:US
Mailing Address - Phone:180-052-8422
Mailing Address - Fax:
Practice Address - Street 1:32545 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-3843
Practice Address - Country:US
Practice Address - Phone:800-528-4223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008099111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty