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General NPI Number Information
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NPI Number | 1780748707
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Entity Type | Organization
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Legal Business Name | JAMES J HEATH DC PC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 403 44TH ST SE
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City | WYOMING
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State | MI
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Zip | 49548-4327
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Country | US
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Telephone | 616-538-1780
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Fax | 616-538-7941
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Provider Business Mailing Address
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Address Line | 403 44TH ST SE
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City | WYOMING
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State | MI
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Zip | 49548-4327
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Country | US
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Telephone | 616-538-1780
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Fax | 616-538-7941
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JEANNIE ANN HEATH
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Credential |
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Telephone | 616-538-1780
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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 | 2301007769
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License Number State | MI
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