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Organization
WEISS CHIROPRACTIC LIFE CENTER PLC
Active
Organization
WEISS CHIROPRACTIC LIFE CENTER PLC
Active
Other names
Weiss Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE ROBERT WEISS DC (OWNER)
(248) 624-9393
Entity
Organization
Contact information
Practice address
44170 W. 12 MILE RD, STE 100, NOVI, MI 48377
(248) 624-9393
(248) 773-8740
Mailing address
44170 W. 12 MILE RD, STE 100, NOVI, MI 48377
(248) 624-9393
(248) 624-6010
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007148
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M69020
MEDICARE ID- TYPE UNSPECIFIED
MI
01
—
168901
SELECTCARE PROVIDER #
MI
05
—
3495449
—
MI
01
—
95035449
BCBS PROVIDER #
MI
01
—
P99468
BCN PROVIDER #
MI
Enumeration date
10/26/2010
Last updated
12/12/2023
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