Individual
ROBERT SCOTT SUPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
16250 NORTHLAND DR # 223, SOUTHFIELD, MI 48075-5205
(877) 401-1440
Mailing address
PO BOX PO BOX 772813, DETROIT, MI 48277-0001
(877) 401-1440
(727) 821-8913
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301011062
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2301011062
STATE LICENSE
MI
Enumeration date
03/14/2022
Last updated
03/14/2022
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