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Organization
VAN BORN CHIROPRACTIC CLINIC, P.C.
Active
Organization
VAN BORN CHIROPRACTIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE IRENE PETHTEL D.C. (PRESIDENT)
(313) 291-1060
Entity
Organization
Contact information
Practice address
23610 VAN BORN RD, DEARBORN HEIGHTS, MI 48125-2356
(313) 291-1060
(313) 291-1089
Mailing address
23610 VAN BORN RD, DEARBORN HEIGHTS, MI 48125-2356
(313) 291-1060
(313) 291-1089
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0Q24591
BCBC MI GROUP ID
MI
Enumeration date
05/08/2006
Last updated
02/05/2024
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