CUSTOM CHIROPRACTIC AND WELLNESS INC (NPI# 1902107931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902107931 |
| Entity Type | Organization |
| Organization Name | CUSTOM CHIROPRACTIC AND WELLNESS INC |
| Practice Address |
3631 S Baldwin Rd Orion MI 48359-1506 |
| Practice Telephone | 2483915400 |
| Practice Fax Number | 2483915404 |
| Mailing Telephone | 2484956066 |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2013-11-21 |
| Authorized Official Name | JASON T OLAFSSON (OWNER) |
| Authorized Official Telephone | 2484956066 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2301009664 | MI | Chiropractic Providers |
| Street Address |
3631 S BALDWIN RD |
| City | ORION |
| State | MI |
| Zip Code | 48359-1506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952755498 | Vmlp Ah Plc | Dentist | 4929 South Baldwin Rd, Ste 104, Lake Orion, MI 48359 | 2016-04-21 |
| 1427307511 | David Andrew Dehaan | Dentist | 3027 S. Baldwin Rd, Lake Orion, MI 48359 | 2012-09-05 |
| 1497838445 | Philip C Krause | Physical Therapist | 3009 South Baldwin Road, Orion, MI 48359 | 2006-10-23 |
| 1528001922 | Steven Paul Cogswell | Family Medicine | 4405 S Baldwin Rd Ste D, Lake Orion, MI 48359 | 2006-06-14 |
| 1912998394 | Mary Jo K Voelpel | Internal Medicine | 3003 S. Baldwin Rd., Suite A, Lake Orion, MI 48359 | 2005-11-03 |
| 1265826804 | Nicholas Tyler Barjaktarovich | Family Medicine | 3003 S Baldwin Rd, Lake Orion, MI 48359 | 2015-03-21 |
| 1841751062 | Carletta Eedsel Horne | Nurse's Aide | 3079 S Baldwin Rd Ste 1050, Lake Orion, MI 48359-1028 | 2019-03-29 |
| 1821453218 | Amanda Lynn Allen | Nurse Practitioner | 3079 S Baldwin Rd Ste 1076, Lake Orion, MI 48359-1028 | 2015-12-29 |
| 1801006333 | Deborah Dehaan, D.d.s., M.s., P.C. | Dentist | 3027 S Baldwin Rd, Lake Orion, MI 48359-1028 | 2007-05-23 |
| 1689786527 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3475 S Baldwin Rd, Orion, MI 48359-1028 | 2006-08-31 |
| Find all providers in zip 48359 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629405584 | Bennett Specific Chiropractic, Inc | Chiropractor | 3385 Waldon Rd, Orion, MI 48360-1648 | 2013-10-08 |
| 1578706461 | Lori Beth Nelson | Chiropractor | 1309 5th St, Orion, IL 61273-7751 | 2009-04-08 |
| 1275797805 | Amador Chiropractic Clinic | Chiropractor | 410 11th Ave, Orion, IL 61273 | 2008-07-14 |
| 1013971464 | Egil T Moen | Chiropractor | 18 12th Ave, Orion, IL 61273 | 2006-04-13 |
| 1194788018 | Christopher Alan Dolecki | Chiropractor | 4110 S Baldwin Rd, Orion, MI 48359-2102 | 2006-04-11 |
| 1538459706 | Austin M Huyten | Chiropractor | 1000 3rd St, Orion, IL 61273-7744 | 2011-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860240 | Moriah K Severance | Chiropractor | 2449 W Kimmel Rd, Jackson, MI 49201-9783 | 2020-10-30 |
| 1760082465 | David Scott Severance | Chiropractor | 11720 Tompkins Rd, Rives Junction, MI 49277-9629 | 2020-10-30 |
| 1760082705 | Kelly Chiropractic Clinic, LLC | Chiropractor | 3179 12 Mile Rd, Berkley, MI 48072-1339 | 2020-10-29 |
| 1619584273 | Sydnee Laree Rutledge | Chiropractor | 3634 Mccain Rd Ste 7, Jackson, MI 49203-2576 | 2020-09-28 |
| 1790391860 | Ferras Dassouki | Chiropractor | 1126 Hunter Ct, Milford, MI 48381-3180 | 2020-09-23 |
| 1811503972 | Nicholas Heiserman | Chiropractor | 498 E Monroe St, Dundee, MI 48131-1321 | 2020-09-23 |
| 1114532835 | Pro-active Chiropractic Wellness of Grand Rapids | Chiropractor | 4270 Plainfield Ave Ne # E, Grand Rapids, MI 49525-1603 | 2020-09-10 |
| 1215540463 | Lake State Chiropractic Pllc | Chiropractor | 2155 84th St Sw Ste 4, Byron Center, MI 49315-8259 | 2020-08-27 |
| 1609488402 | Primrose Family Chiropractic and Wellness Center | Chiropractor | 25900 Greenfield Rd Suite 252, Oak Park, MI 48237-1297 | 2020-08-21 |
| 1780295063 | Wilhelm Family Chiropractic and Massage Pllc | Chiropractor | 23200 Pontiac Trl, South Lyon, MI 48178-1983 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.