Healthcare Provider Details

I. General information

NPI: 1821939588
Provider Name (Legal Business Name): MEGHAN LEE GOODRICH D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 KALAMAZOO AVE SE
GRAND RAPIDS MI
49508-7890
US

IV. Provider business mailing address

76845 39TH ST
DECATUR MI
49045-9190
US

V. Phone/Fax

Practice location:
  • Phone: 616-439-9705
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401678
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: