NPIMap

Organization Active NPI

Advance Chiropractic

  • Chiropractor
  • Taylor, MI
National Provider Identifier
1770975906
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ADVANCE CHIROPRACTIC
Practice address
25507 Ecorse Rd
Taylor, MI 48180-1555
Phone
(313) 436-0041
NPI assigned
Feb 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Authorized official

Name
Dr. Reza Hafezi
Title
Owner
Phone
(313) 436-0041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

25507 Ecorse Rd
Taylor, MI 48180-1555

Mailing address

25507 Ecorse Rd
Taylor, MI 48180-1555

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1770975906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25507 ECORSE RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25507 ECORSE RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801555",
            "telephone_number": "313-436-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "HAFEZI",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-436-0041",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.