Healthcare Provider Details

I. General information

NPI: 1407826555
Provider Name (Legal Business Name): DOUGLAS EARL PIERCE D. C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1394 DAIRY LN NE
CEDAR SPRINGS MI
49319-8131
US

IV. Provider business mailing address

1394 DAIRY LN NE
CEDAR SPRINGS MI
49319-8131
US

V. Phone/Fax

Practice location:
  • Phone: 616-696-6144
  • Fax: 616-696-6144
Mailing address:
  • Phone: 616-696-6144
  • Fax: 616-696-6144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301005317
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: