Healthcare Provider Details

I. General information

NPI: 1265356455
Provider Name (Legal Business Name): PRESTON OWINGS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4288 3 MILE RD NW STE 2
GRAND RAPIDS MI
49534-7596
US

IV. Provider business mailing address

4288 3 MILE RD NW STE 2
GRAND RAPIDS MI
49534-7596
US

V. Phone/Fax

Practice location:
  • Phone: 616-453-0600
  • Fax:
Mailing address:
  • Phone: 616-453-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401771
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: