Individual
DR. DEREK PATRICK KACZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
15175 S DIXIE HWY STE A, MONROE, MI 48161-5038
(734) 244-4285
Mailing address
481 PIN OAK CT, MONROE, MI 48162-3391
(470) 262-3107
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301010482
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OP029240
—
MI
Enumeration date
09/30/2016
Last updated
11/13/2019
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