Organization
BRANDON CHIROPRACTIC CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY A STARK DC (OWNER)
(248) 627-9595
Entity
Organization
Contact information
Practice address
70 ORTONVILLE RD, BRANDON CHIROPRACTIC CENTER, ORTONVILLE, MI 48462
(248) 627-9595
(248) 627-9379
Mailing address
70 ORTONVILLE RD, BRANDON CHIROPRACTIC CENTER, ORTONVILLE, MI 48462
(248) 627-9595
(248) 627-9379
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
JS007228
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950F354120
BCBS
—
01
—
P107713
BCN HMO
—
Enumeration date
10/23/2006
Last updated
09/26/2007
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