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General NPI Number Information
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NPI Number | 1043297161
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Entity Type | Individual
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Provider Name | KATHI JUNE GRIFHORST DC
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Gender | Female
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 12489 18 MILE RD
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City | GOWEN
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State | MI
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Zip | 49326-9732
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Country | US
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Telephone | 616-984-9983
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Fax | 616-984-9983
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Provider Business Mailing Address
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Address Line | 12489 18 MILE RD
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City | GOWEN
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State | MI
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Zip | 49326-9732
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Country | US
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Telephone | 616-984-9983
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Fax | 616-984-9983
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301008285
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License Number State | MI
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