NPIMap

Organization Active NPI

Livonia Back & Neck Pain Clinic

  • Chiropractor
  • Livonia, MI
National Provider Identifier
1144337106
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
T97310 Issued in MI
Legal business name
LIVONIA BACK & NECK PAIN CLINIC
Practice address
36016 5 Mile Rd
Livonia, MI 48154-1918
Phone
(734) 591-0404
Fax
(734) 591-1534
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Joseph Brace, D.C.
Title
Owner
Phone
(734) 591-0404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X T97310 MI Primary

Addresses

Primary practice location

36016 5 Mile Rd
Livonia, MI 48154-1918

Mailing address

36016 5 Mile Rd
Livonia, MI 48154-1918
Phone (734) 591-0404

Other identifiers 1

IdentifierTypeStateIssuer
JB003044OtherMILICENSE NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144337106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36016 5 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541918",
            "telephone_number": "734-591-0404",
            "fax_number": "734-591-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36016 5 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541918",
            "telephone_number": "734-591-0404",
            "fax_number": "734-591-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVONIA BACK & NECK PAIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRACE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-591-0404",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "T97310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "JB003044",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.