Pro-Active Chiropractic & Wellness

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PRO-ACTIVE CHIROPRACTIC & WELLNESS

Practice address

6507 Town Center Dr Ste F
Clarkston, MI 48346-4826

Phone

(248) 625-7600

Fax

(616) 288-7901

NPI assigned

Oct 31, 2018

Organization subpart

No

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

Authorized official

Name

April Cowan

Title

Office Manager

Phone

(248) 625-7600

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1306313044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR STE F",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826",
            "telephone_number": "248-625-7600",
            "fax_number": "248-625-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR STE F",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826",
            "telephone_number": "248-625-7600",
            "fax_number": "616-288-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-ACTIVE CHIROPRACTIC & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2022-08-09",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-625-7600"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1902155096",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2301009883",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justine Potthast, LMSW
• Jorge A Prada, CNS
• Precision Dna Solutions
• Premier Home Health Options, LLC
• Premiere Pediatrics, PC
• Pro-Active Chiropractic & Wellness, II PC
• Progressive Lifestyle Inc
• Progressive Lifestyle Inc
• Progressive Lifestyle Inc
• Progressive Lifestyle Inc

• Chiropractor in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.