Dynamic Life of Michigan, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DYNAMIC LIFE OF MICHIGAN, LLC

Practice address

33966 W 8 Mile Rd
Suite 103
Farmington, MI 48335-5273

Phone

(616) 813-3377

NPI assigned

Feb 27, 2010

Last updated

Mar 2, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Judge, D.C.

Title

Regional Director

Phone

(248) 593-0843

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1267228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1477875755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S ADAMS RD",
            "address_2": "SUITE 198",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096902",
            "telephone_number": "248-593-0843",
            "fax_number": "248-593-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33966 W 8 MILE RD",
            "address_2": "SUITE 103",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483355273",
            "telephone_number": "616-813-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC LIFE OF MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-27",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "JUDGE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "248-593-0843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.