| Fountain Chiro Llc | |
|
24640 Telegraph Rd, Flat Rock, MI 48134-9226 | |
| (734) 782-0200 | |
| (734) 782-0200 |
| Full Name | Fountain Chiro Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 24640 Telegraph Rd, Flat Rock, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013467323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 2301009847 (Michigan) | Primary |
| Provider Name | Jason P Laske |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1437192093 PECOS PAC ID: 5799782603 Enrollment ID: I20061106000430 |
| Provider Name | Greg Ross Fountain |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033492756 PECOS PAC ID: 8123295912 Enrollment ID: I20120119000239 |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Chiro Llc 24640 Telegraph Rd, Flat Rock, MI 48134-9226 Ph: (734) 782-0200 | Fountain Chiro Llc 24640 Telegraph Rd, Flat Rock, MI 48134-9226 Ph: (734) 782-0200 |
Liedel Chiropractic Clinic, Inc Chiropractor Medicare: Medicare Enrolled Practice Location: 27108 Telegraph Rd, Flat Rock, MI 48134 Phone: 734-783-5040 | |
Dr. Greg Ross Fountain, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 24640 Telegraph Rd, Flat Rock, MI 48134 Phone: 734-652-7259 | |
Dr. Cara Hope Phillips, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 29100 Gateways Blvd., Suite 100, Flat Rock, MI 48134 Phone: 734-379-9200 Fax: 734-379-9229 | |
Thomas A Clark, D.O. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 29100 Gateway Blvd, Ste 100, Flat Rock, MI 48134 Phone: 734-379-9200 Fax: 734-379-9229 | |
Porter & Clark Chiropractic Pllc Chiropractor Medicare: Medicare Enrolled Practice Location: 29100 Gateway Blvd, Ste 100, Flat Rock, MI 48134 Phone: 734-379-9200 Fax: 734-379-9229 | |
Cory T Borawski, D.C. ( CHIROPRACTIC) Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 27108 Telegraph Road, Liedel Chiropractic Clinic, Flat Rock, MI 48134 Phone: 734-783-5040 Fax: 734-783-5403 |