MEDICARE: TOTAL HEALTH SPINE & SPORT, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301008037	MI

General Provider Information

NPI Number	:	1902099757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HEALTH SPINE & SPORT, P.C.

Provider Business Mailing Address
First Line	:	2843 E GRAND RIVER AVE STE 170
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-6723
Country	:	US
Telephone Number	:	517-337-7463
Fax Number	:	517-337-7453

Provider Business Practice Location Address
First Line	:	2843 E GRAND RIVER AVE
Second Line	:	SUITE 170
City	:	EAST LANSING
State	:	MI
Zip	:	48823-6722
Country	:	US
Telephone Number	:	517-337-7463
Fax Number	:	517-337-7453

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KENNETH EARL ROGERS
Credential	:	DC
Telephone Number	:	517-337-7463

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	11/21/2025

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