Organization
DESIRA CHIROPRACTIC LIFE CENTER LLC
Active
Organization
DESIRA CHIROPRACTIC LIFE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD GERARD DESIRA DC (DIRECTOR)
(734) 422-7800
Entity
Organization
Contact information
Practice address
33250 WARREN RD, WESTLAND, MI 48185-2920
(734) 422-7800
Mailing address
33250 WARREN RD, WESTLAND, MI 48185-2920
(734) 422-7800
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2301005025
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4951482
—
MI
01
—
95OH225380
BCBS MICHIGAN
MI
Enumeration date
01/16/2008
Last updated
01/16/2008
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