Provider Demographics
NPI:1487949640
Name:GIULIO J COGO DC PC
Entity type:Organization
Organization Name:GIULIO J COGO DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GIULIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:COGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-227-7799
Mailing Address - Street 1:5889 WHITMORE LAKE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1998
Mailing Address - Country:US
Mailing Address - Phone:810-227-7799
Mailing Address - Fax:810-227-8999
Practice Address - Street 1:5889 WHITMORE LAKE RD
Practice Address - Street 2:SUITE C
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1998
Practice Address - Country:US
Practice Address - Phone:810-227-7799
Practice Address - Fax:810-227-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGC002816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI144459151Medicaid
MIT33099Medicare UPIN