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General NPI Number Information
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NPI Number | 1124698972
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Entity Type | Organization
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Legal Business Name | JFC
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 6293 KENOWA AVE SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-9405
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Country | US
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Telephone | 616-730-1137
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Fax |
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Provider Business Mailing Address
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Address Line | 1594 LAKESIDE DR
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City | HUDSONVILLE
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State | MI
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Zip | 49426-8101
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Country | US
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Telephone | 989-370-3563
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. RONALD H RABINEAU III
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Credential | DC
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Telephone | 989-370-3563
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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 |
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License Number State |
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