Healthcare Provider Details

I. General information

NPI: 1922391051
Provider Name (Legal Business Name): HIGHER HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2011
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 GEZON PKWY SW
WYOMING MI
49509-9542
US

IV. Provider business mailing address

5298 PALMAIR DR SW
WYOMING MI
49418-9300
US

V. Phone/Fax

Practice location:
  • Phone: 616-401-2803
  • Fax:
Mailing address:
  • Phone: 616-401-2803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009810
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number2301009810
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2301009810
License Number StateMI

VIII. Authorized Official

Name: DR. ERIK KOWALKE
Title or Position: OWNER
Credential: D.C.
Phone: 616-401-2803