Bronco Injury & Chiropractic Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009312 Issued in MI

Legal business name

BRONCO INJURY & CHIROPRACTIC CENTER, INC.

Practice address

23077 Greenfield Rd Ste 460
Southfield, MI 48075-3754

Phone

(248) 644-6272

Fax

(248) 644-6276

NPI assigned

Jun 5, 2014

Last updated

Apr 9, 2024By 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. Raphael Okonkwor, DCNPI 1235279928

Title

Owner

Phone

(248) 644-6272

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Bronco Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bronco Injury & Chiropractic Center, Inc.

  • Chiropractor
  • Southfield, MI
  • NPI 1144536954
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raphael Chigozie Okonkwor, D.C.

  • Chiropractor
  • Southfield, MI
  • NPI 1235279928
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1548673791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 460",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753754",
            "telephone_number": "248-644-6272",
            "fax_number": "248-644-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 460",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753754",
            "telephone_number": "248-644-6272",
            "fax_number": "248-644-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONCO INJURY & CHIROPRACTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "OKONKWOR",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-644-6272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Brock
• Anthony Lee Brock Jr.
• Margaret Brockmeyer-Bernard, DDS
• Abbigail Broderick
• Bronco Injury & Chiropractic Center, Inc.
• Rachel Bronfin
• Aldrich M Brooks, M.D.
• Arletha Ann Brooks
• Cedric Lamar Brooks, LPC
• Destiny Brooks

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.