Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2301009804 | MI |
N | 111NN0400X | Neurology | 1992207 | MI |
NPI | 1891075040 |
---|---|
Provider Name | Dr. James Ross Muldoon |
First Address | Wixom, MI 48393-3430 |
Second Address | Wixom, MI 48393-3430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2011 |
Last Update Date | 09/11/2015 |