Provider Demographics
NPI:1043014236
Name:CHILDS, JOSHUA (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:CHILDS
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 MARSH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-9241
Mailing Address - Country:US
Mailing Address - Phone:313-600-6890
Mailing Address - Fax:
Practice Address - Street 1:1412 ECORSE RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5985
Practice Address - Country:US
Practice Address - Phone:734-482-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor