Organization Name: | KOTILA CHIROPRACTIC LIFE CENTER |
NPI Number: | 1811910821 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY J KOTILA (PRESIDENT) |
Mailing Address: | 30400 Telegraph Rd Ste 116 Bingham Farms |
State: | MI US |
Postal Code: | 480254538 |
Phone Number: | 2486424550 |
Fax Number: | 2486428187 |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 2301002841 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |