Great Lakes Family Chiropractic, Inc. in Kentwood - Chiropractor
Great Lakes Family Chiropractic, Inc. - NPI 1811975717
Great Lakes Family Chiropractic, Inc. is a Chiropractor in Kentwood, Michigan. Great Lakes Family Chiropractic, Inc. practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Great Lakes Family Chiropractic, Inc. is 1811975717. The last update date is 2020-08-22.
Great Lakes Family Chiropractic, Inc.'s current location address is 3138 Broadmoor Ave Se, Kentwood, Michigan. You can contact this provider via phone number 6162414040 and fax number 6164756953. The mailing address for Great Lakes Family Chiropractic, Inc. is 3138 Broadmoor Ave Se, Kentwood, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Great Lakes Family Chiropractic, Inc. |
|---|---|
| Address | 3138 Broadmoor Ave Se, Kentwood, Michigan |
| Phone Number | 6162414040 |
| Fax Number | 6164756953 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DR. OWNER |
|---|---|
| Authorized Official Name | Mckenzie Gene Douglas |
| Credentials | D.C. |
| Telephone Number | 6162414040 |
NPI Number Detail
| NPI Number | 1811975717 |
|---|---|
| Provider Enumeration Date | 2006-01-03 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 3138 Broadmoor Ave Se |
|---|---|
| City | Kentwood |
| State | Michigan (MI) |
| Post Code | 495121845 |
| Phone Number | 6162414040 |
| Fax Number | 6164756953 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 2301008451 |
|
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 inte |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4754106 | MI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Great Lakes Family Chiropractic, Inc. by the Centers for Medicare & Medicaid Services?
The Great Lakes Family Chiropractic, Inc. has been assigned the NPI (National Provider Identifier) 1811975717 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Great Lakes Family Chiropractic, Inc.'s facilities are situated?
The facilities of Great Lakes Family Chiropractic, Inc. are physically located at the following address: 3138 Broadmoor Ave Se, Kentwood, MI, 495121845.
What is the Great Lakes Family Chiropractic, Inc.'s area of specialization and corresponding taxonomy classification?
The Great Lakes Family Chiropractic, Inc.'s specialty field is Chiropractor, and it falls under the taxonomy code 111N00000X, which categorizes healthcare providers based on their specialties.
On what date did the Great Lakes Family Chiropractic, Inc. receive the assignment of its 1811975717 from the Centers for Medicare & Medicaid Services?
The Great Lakes Family Chiropractic, Inc. was issued its 1811975717 by the Centers for Medicare & Medicaid Services on 2006-01-03.
As of what date were the details pertaining to Great Lakes Family Chiropractic, Inc. last refreshed?
The information related to the Great Lakes Family Chiropractic, Inc., including its address, specialty, and other relevant details, was last updated on 2020-08-22.
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