| Shallow Chiropractic Pc | |
|
24820 Michigan Ave, Dearborn, MI 48124-1713 | |
| (313) 277-3766 | |
| (313) 277-7196 |
| Full Name | Shallow Chiropractic Pc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 24820 Michigan Ave, Dearborn, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710988068 | NPI | - | NPPES |
| RS004116 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 2301004116 (Michigan) | Primary |
| Provider Name | Randy J Shallow |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1609906866 PECOS PAC ID: 7012069461 Enrollment ID: I20090715000386 |
| Mailing Address | Practice Location Address |
|---|---|
| Shallow Chiropractic Pc 24820 Michigan Ave, Dearborn, MI 48124-1713 Ph: (313) 277-3766 | Shallow Chiropractic Pc 24820 Michigan Ave, Dearborn, MI 48124-1713 Ph: (313) 277-3766 |
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Dr. Jeremy Dennis Copple, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 22615 Michigan Ave, Dearborn, MI 48124 Phone: 313-585-1517 | |
Yi Xie, Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 22615 Michigan Ave, Dearborn, MI 48124 Phone: 563-508-5737 | |
Abduldayem Ahmed, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 9925 Dix, Suite 102, Dearborn, MI 48120 Phone: 313-841-1470 | |
Erich Werner Walter, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 15700 Michigan Avenue, Dearborn, MI 48126 Phone: 313-582-4334 |