Provider Demographics
NPI:1962719203
Name:NORTHLAND HEALTHCARE SERVICES PLLC
Entity type:Organization
Organization Name:NORTHLAND HEALTHCARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:KEMOLI
Authorized Official - Last Name:SAGALA
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:248-850-7660
Mailing Address - Street 1:23300 GREENFIELD RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-5237
Mailing Address - Country:US
Mailing Address - Phone:248-850-7660
Mailing Address - Fax:248-850-7740
Practice Address - Street 1:23300 GREENFIELD RD
Practice Address - Street 2:SUITE 205
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-5237
Practice Address - Country:US
Practice Address - Phone:248-850-7660
Practice Address - Fax:248-850-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI004989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty