Liedel Chiropractic Clinic, Inc

Primary specialty

Occupational Health ChiropractorTaxonomy code 111NX0100X

License

2301005513 Issued in MI

Legal business name

LIEDEL CHIROPRACTIC CLINIC, INC

Practice address

27108 Telegraph Rd
Flat Rock, MI 48134-1659

Phone

(734) 783-5040

NPI assigned

Jan 7, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ronald H Liedel Jr.NPI 1619035490

Title

D.C.

Phone

(734) 783-5040

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald Harlan Liedel Jr., D.C.

  • Radiology Chiropractor
  • Flat Rock, MI
  • NPI 1619035490
  Medicare reassignment NPD Authorized official
• Cory T Borawski, D.C. ( CHIROPRACTIC)

  • Chiropractor
  • Fenton, MI
  • NPI 1326698655
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294358400000",
    "number": "1033413836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27108 TELEGRAPH RD",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341659",
            "telephone_number": "734-783-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27108 TELEGRAPH RD",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341659",
            "telephone_number": "734-783-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIEDEL CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A",
        "authorized_official_last_name": "LIEDEL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "D.C.",
        "authorized_official_telephone_number": "734-783-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": "MI",
            "license": "2301005513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3302328",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Jane Kmiotek
• Kroger Co of Michigan
• Jason P Laske, DC
• Maegen L Laub, LMSW
• Amy Lynn Lewis, RN
• Ronald Harlan Liedel Jr., D.C.
• Livewell Home Health Care, LLC
• Drew Mankowski
• Monica Ann Mannino, PT
• Rachel Jillene McDonald

• Occupational Health Chiropractor in Flat Rock, MI
• Providers in Flat Rock, MI by specialty
• Occupational Health Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.