Healthcare Provider Details

I. General information

NPI: 1144205956
Provider Name (Legal Business Name): RHONDA VOSS PETSCH D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W COLBY ST
WHITEHALL MI
49461-2005
US

IV. Provider business mailing address

104 W COLBY ST
WHITEHALL MI
49461-2005
US

V. Phone/Fax

Practice location:
  • Phone: 231-894-2900
  • Fax: 231-893-1144
Mailing address:
  • Phone: 231-894-2900
  • Fax: 231-893-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2301006906
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: