Healthcare Provider Details

I. General information

NPI: 1609364066
Provider Name (Legal Business Name): GREGORY SWETS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 MICHIGAN ST NE STE 101
GRAND RAPIDS MI
49506-1215
US

IV. Provider business mailing address

2851 MICHIGAN ST NE STE 101
GRAND RAPIDS MI
49506-1215
US

V. Phone/Fax

Practice location:
  • Phone: 616-940-7027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010675
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: