Healthcare Provider Details

I. General information

NPI: 1033423926
Provider Name (Legal Business Name): KB CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2010
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5164 LAKE MICHIGAN DR STE D
ALLENDALE MI
49401-8506
US

IV. Provider business mailing address

5164 LAKE MICHIGAN DR
ALLENDALE MI
49401-8505
US

V. Phone/Fax

Practice location:
  • Phone: 616-777-0309
  • Fax: 616-777-0523
Mailing address:
  • Phone: 616-777-0309
  • Fax: 616-777-0523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. KELLEN I BRUSVEEN
Title or Position: PHYSICIAN/CEO
Credential: D.C.
Phone: 616-502-8468