Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2301009447 | MI |
NPI | 1003243452 |
---|---|
Provider Name | Dr. Edward C Guzak |
First Address | Waterford, MI 48327-1912 |
Second Address | Waterford, MI 48327-1912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2013 |
Last Update Date | 01/10/2013 |