Cooley Lake Neck And Back Care Clinic LLC
Chiropractor in Commerce Township, MI. Organization (NPI-2).
NPI number1124336433
StatusActive
Last updated in NPPESSep 9, 2011
Details
- NPI
- 1124336433
- Entity type
- Organization (NPI-2)
- Legal business name
- Cooley Lake Neck And Back Care Clinic LLC
- Organization subpart
- No
- Enumeration date
- Sep 21, 2010
- Last updated
- Sep 9, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
Practice location
2171 N Pontiac TrlCommerce Township, MI 48390-3162
Phone 248-926-4050 · Fax 248-926-4050
Mailing address
2171 N Pontiac TrlCommerce Township, MI 48390-3162
Phone 248-926-4050 · Fax 248-926-4050
Authorized official
Jason Limbacher
Owner
2489264050
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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