Organization
JONATHAN CROMWELL D.C., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN DALE CROMWELL D.C. (PRESIDENT)
(248) 477-1492
Entity
Organization
Contact information
Practice address
23280 FARMINGTON RD, FARMINGTON, MI 48336-3100
(248) 477-1492
(248) 474-9099
Mailing address
23280 FARMINGTON RD, FARMINGTON, MI 48336-3100
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005887
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2831233
—
MI
01
—
950F35388
BLUE CROSS BLUE SHIELD OF MICIGAN
MI
Enumeration date
12/30/2011
Last updated
06/09/2012
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