Healthcare Provider Details

I. General information

NPI: 1598898348
Provider Name (Legal Business Name): ERIC KEES PEET DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3413 ELIZABETH ST
SAUGATUCK MI
49453-9736
US

IV. Provider business mailing address

P O BOX 489 3413 ELIZABETH ST
SAUGATUCK MI
49453
US

V. Phone/Fax

Practice location:
  • Phone: 269-857-5105
  • Fax: 269-857-5213
Mailing address:
  • Phone: 269-857-5105
  • Fax: 269-857-5213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberEP006039
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: