Provider Demographics
NPI:1699882951
Name:AHAD E LOTFI DC PLLC
Entity type:Organization
Organization Name:AHAD E LOTFI DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOTFI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-621-3800
Mailing Address - Street 1:60069 COUNTY ROAD 687
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49057-9601
Mailing Address - Country:US
Mailing Address - Phone:269-621-3800
Mailing Address - Fax:269-621-2556
Practice Address - Street 1:60069 COUNTY ROAD 687
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:MI
Practice Address - Zip Code:49057-9601
Practice Address - Country:US
Practice Address - Phone:269-621-3800
Practice Address - Fax:269-621-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3427986Medicaid
MI95OHO50160OtherBCBS
MI3427986Medicaid
MIU67929Medicare UPIN