Healthcare Provider Details

I. General information

NPI: 1760735641
Provider Name (Legal Business Name): PAUL ALAN KAMINSKI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL ALAN KAMINSKI JR. D.C.

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4930 CASCADE RD SE STE A
GRAND RAPIDS MI
49546-3884
US

IV. Provider business mailing address

4930 CASCADE RD SE STE A
GRAND RAPIDS MI
49546-3884
US

V. Phone/Fax

Practice location:
  • Phone: 616-288-5999
  • Fax:
Mailing address:
  • Phone: 616-288-5999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009966
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: