Individual provider · NPI-1

Dr. Bryan Born, DC

Chiropractor · Southfield, MI

NPI number1750378659
StatusActive
Last updated in NPPESSep 17, 2012

Details

NPI
1750378659
Entity type
Individual (NPI-1)
Name
Dr. Bryan Born
Credential
DC
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 5, 2005
Last updated
Sep 17, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor2301005852MIYes

Practice location

15831 W 12 Mile Rd
Southfield, MI 48076-3011

Phone 248-559-6763

Mailing address

15831 W 12 Mile Rd
Southfield, MI 48076-3011

Phone 248-559-6763

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