Healthcare Provider Details

I. General information

NPI: 1003642539
Provider Name (Legal Business Name): VANWINKLE FAMILY CHIROPRACTIC PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2963 W DICKMAN RD
SPRINGFIELD MI
49037-7939
US

IV. Provider business mailing address

10507 S MACKINAC TRL
DAFTER MI
49724-9550
US

V. Phone/Fax

Practice location:
  • Phone: 269-986-8903
  • Fax:
Mailing address:
  • Phone: 269-986-8903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER VANWINKLE
Title or Position: OWNER
Credential: DC
Phone: 269-986-8903