Healthcare Provider Details

I. General information

NPI: 1689040867
Provider Name (Legal Business Name): MEGAN JEFFREY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 MICHIGAN AVE
HOLLAND MI
49423-4750
US

IV. Provider business mailing address

509 MICHIGAN AVE
HOLLAND MI
49423-4750
US

V. Phone/Fax

Practice location:
  • Phone: 616-396-4400
  • Fax: 616-392-3806
Mailing address:
  • Phone: 616-396-4400
  • Fax: 163-923-8066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010284
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: