Healthcare Provider Details
I. General information
NPI: 1891419263
Provider Name (Legal Business Name): NEURODC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2022
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8152 N 32ND ST STE C
RICHLAND MI
49083-8500
US
IV. Provider business mailing address
8152 N 32ND ST STE C
RICHLAND MI
49083-8500
US
V. Phone/Fax
- Phone: 269-267-8459
- Fax:
- Phone: 269-267-8459
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN0400X |
| Taxonomy | Neurology Chiropractor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JEFFREY
KURTZ
Title or Position: OWNER
Credential: DC
Phone: 269-350-9000