Healthcare Provider Details

I. General information

NPI: 1922941426
Provider Name (Legal Business Name): MEGHAN MARIE GORSUCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3044 THORNAPPLE RIVER DR SE
GRAND RAPIDS MI
49546-7137
US

IV. Provider business mailing address

3044 THORNAPPLE RIVER DR SE
GRAND RAPIDS MI
49546-7137
US

V. Phone/Fax

Practice location:
  • Phone: 616-481-1012
  • Fax:
Mailing address:
  • Phone: 616-481-1012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401711
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: