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Dr. Randolph Clay O'dell, DC
Chiropractor in Walled Lake, Michigan
NPI 1477644375

Randolph Clay O'dell is a Chiropractor based in Walled Lake, MI. Randolph Clay O'dell practices in Walled Lake, MI and has the professional credentials of DC. The NPI Number for Randolph Clay O'dell is 1477644375 and holds a License No. 2301002842 (Michigan).

The current practice location address for Randolph Clay O'dell is 1183 Pontiac Trail, Walled Lake, MI and can be reached out via phone at 248-624-6111 and via fax at 248-624-6129.

Location: 1183 Pontiac Trail, Walled Lake, MI, 48390
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477644375
Provider Name
Randolph Clay O'dell
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
1183 Pontiac Trail, Walled Lake, MI, 48390
Phone Number
248-624-6111
Fax Number
248-624-6129
Provider Enumeration Date
09/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1279839 05 MI
142073 01 MI AETNA INSURANCE
institution
Provider Business Practice Location Address Details
Address
1183 Pontiac Trail
City
Walled Lake
State
Michigan
Zip
48390
Phone Number
248-624-6111
Fax Number
248-624-6129
person
Provider Business Mailing Address Details
Address
1183 Pontiac Trail
City
Walled Lake
State
Michigan
Zip
48390
Phone Number
248-624-6111
Fax Number
248-624-6129
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
2301002842 (Michigan)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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