Provider Demographics
NPI:1447957147
Name:PRO MOTION CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PRO MOTION CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:MECHALKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-912-8239
Mailing Address - Street 1:827 WESTBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-1667
Mailing Address - Country:US
Mailing Address - Phone:248-912-8239
Mailing Address - Fax:
Practice Address - Street 1:827 WESTBROOKE DR
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1667
Practice Address - Country:US
Practice Address - Phone:248-912-8239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty