Organization
MOSURAK CHIROPRACTIC & WELLNESS CENTER, LLC
Active
Other names
Warren Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE MOSURAK III DC (CHIROPRACTOR/OWNER)
(810) 459-9144
Entity
Organization
Contact information
Practice address
6201 CHICAGO RD, WARREN, MI 48092-4755
(586) 264-3621
Mailing address
4275 GRATIOT AVE, FORT GRATIOT, MI 48059-3900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649669425
TYPE 1 NPI
—
01
—
2301010264
STATE LICENSE NUMBER
MI
Enumeration date
02/20/2019
Last updated
02/20/2019
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