Healthcare Provider Details

I. General information

NPI: 1952349235
Provider Name (Legal Business Name): CHIROPRACTIC PLUS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

0 699 TALLMADGE WDS NW SUITE B
GRAND RAPIDS MI
49534
US

IV. Provider business mailing address

0 699 TALLMADGE WDS NW SUITE B
GRAND RAPIDS MI
49534
US

V. Phone/Fax

Practice location:
  • Phone: 616-791-9702
  • Fax: 616-791-4661
Mailing address:
  • Phone: 616-791-9702
  • Fax: 616-791-4661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2301004871
License Number StateMI

VIII. Authorized Official

Name: DR. DANIEL J OHLMAN
Title or Position: OWNER
Credential: D.C.
Phone: 616-791-9702