Spine and Wellness LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

2301010613 Issued in MI

Legal business name

SPINE AND WELLNESS LLC

Practice address

39880 Van Dyke Ave Ste 201
Sterling Heights, MI 48313-4670

Phone

(586) 745-1021

NPI assigned

Jan 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Burgess, DC

Title

Owner/Chiropractor

Phone

(586) 556-1060

Specialties & licenses 1

Addresses

Other names 1

• Sterling Heights Spine and Wellness Doing business as

Locations

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1154839231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39880 VAN DYKE AVE STE 201",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134670",
            "telephone_number": "586-745-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39880 VAN DYKE AVE STE 201",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134670",
            "telephone_number": "586-745-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "586-556-1060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "2301010613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sterling Heights Spine and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Spencer, LLMSW
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• Ashley Spicer
• Donna Spicuzzi, MSW
• Sydney Lynn Sponkowski, CCC-SLP
• Carolyn Sprague, M.D.
• Karin Melanie Spresney Wozniak, PT, MPT
• Kathy Ann Spudich
• Sriram Srinivasan, PT

• Clinic/Center in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.