4TH Street Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010018 Issued in MI

Legal business name

4TH STREET CHIROPRACTIC INC

Practice address

117 W 4TH St
Rochester, MI 48307-2025

Phone

(248) 841-1785

NPI assigned

Mar 19, 2013

Last updated

Mar 19, 2013By 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

Mr. Stephen Vallecorse, DCNPI 1851636955

Title

Owner

Phone

(248) 841-1785

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Stephen Michael Vallecorse, D.C.

  • Chiropractor
  • Rochester, MI
  • NPI 1851636955
  Authorized official Same address or phone
• Jennifer Amy McDonald, P.T.

  • Physical Therapist
  • Warren, MI
  • NPI 1215132006
  NPD (past)

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1639411465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 4TH ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072025",
            "telephone_number": "248-841-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 4TH ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072025",
            "telephone_number": "248-841-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4TH STREET CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "VALLECORSE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-841-1785",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.