Provider Demographics
NPI:1669716551
Name:CHELSEA CHIROPRACTIC & FUNCTIONAL NEUROLOGY LLC
Entity type:Organization
Organization Name:CHELSEA CHIROPRACTIC & FUNCTIONAL NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FUNCTIONAL NEUROLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KEISER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:734-845-1080
Mailing Address - Street 1:20780 ISLAND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-9584
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 W MIDDLE ST
Practice Address - Street 2:SUITE E
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1293
Practice Address - Country:US
Practice Address - Phone:734-845-1080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010030111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty