Healthcare Provider Details

I. General information

NPI: 1962323360
Provider Name (Legal Business Name): WALTMAN FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4286 CASCADE RD SE
GRAND RAPIDS MI
49546-8301
US

IV. Provider business mailing address

4286 CASCADE RD SE
GRAND RAPIDS MI
49546-8301
US

V. Phone/Fax

Practice location:
  • Phone: 248-259-1153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN WALTMAN
Title or Position: OWNER/OPERATOR
Credential: DC
Phone: 248-259-1153