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Organization

PROSPINE AND SPORTS P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DUSTIN MATTILA D.C. (PRESIDENT)
(248) 615-1381
Entity
Organization

Contact information

Practice address
32738 GRAND RIVER AVE, FARMINGTON, MI 48336-3132
(248) 615-1381
Mailing address
32738 GRAND RIVER AVE, FARMINGTON, MI 48336-3132

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009748
MI

Other

Enumeration date
06/04/2013
Last updated
06/04/2013
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