Healthcare Provider Details

I. General information

NPI: 1861459240
Provider Name (Legal Business Name): MARC D HEMMEKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 MICHIGAN AVE HOLLAND CHIROPRACTIC CENTER PC
HOLLAND MI
49423
US

IV. Provider business mailing address

509 MICHIGAN AVE
HOLLAND MI
49423
US

V. Phone/Fax

Practice location:
  • Phone: 616-396-4400
  • Fax: 616-392-8645
Mailing address:
  • Phone: 616-396-4400
  • Fax: 616-392-8645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009070
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: