Healthcare Provider Details

I. General information

NPI: 1598023384
Provider Name (Legal Business Name): INSPIRED HEALTH CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 WAVERLY AVE
GRAND HAVEN MI
49417-2392
US

IV. Provider business mailing address

1428 WAVERLY AVE
GRAND HAVEN MI
49417-2392
US

V. Phone/Fax

Practice location:
  • Phone: 616-846-3860
  • Fax:
Mailing address:
  • Phone: 616-846-3860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2301009795
License Number StateMI

VIII. Authorized Official

Name: DR. JASMINE LENA HORNBERGER
Title or Position: OWNER
Credential: D.C.
Phone: 616-846-3860