Healthcare Provider Details

I. General information

NPI: 1295445799
Provider Name (Legal Business Name): GREAT LAKES CHIROPRACTIC PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2022
Last Update Date: 05/20/2023
Certification Date: 05/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5136 CASCADE RD SE STE 1D
GRAND RAPIDS MI
49546-3728
US

IV. Provider business mailing address

5136 CASCADE RD SE STE 1D
GRAND RAPIDS MI
49546-3728
US

V. Phone/Fax

Practice location:
  • Phone: 810-310-1207
  • Fax:
Mailing address:
  • Phone: 181-031-0120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER SASS
Title or Position: OWNER
Credential: DC
Phone: 810-310-1207