Organization
PLYMOUTH CHIROPRACTIC WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH ANNE SISK DC (OWNER)
(734) 459-7090
Entity
Organization
Contact information
Practice address
908 PENNIMAN AVE, PLYMOUTH, MI 48170-1624
(734) 453-7090
(734) 453-9992
Mailing address
908 PENNIMAN AVE, PLYMOUTH, MI 48170-1624
(734) 453-7090
(734) 453-9992
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316980287
DR E NPI
MI
01
—
1316980337
DR OMEL NPI
MI
01
—
950H228250
BCBS OF MICHIGAN
MI
01
—
950H228640
BLUE CARE NETWORK (DR.E BCBS ID NUMBER)
MI
Enumeration date
08/20/2006
Last updated
01/27/2009
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