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General NPI Number Information
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NPI Number | 1952471294
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH GORDON-ARNTSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 6491 SAN RU AVE STE B
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City | JENISON
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State | MI
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Zip | 49428-8185
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Country | US
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Telephone | 616-669-8880
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Fax | 616-669-2241
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Provider Business Mailing Address
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Address Line | 6491 SAN RU AVE STE B
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City | JENISON
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State | MI
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Zip | 49428-8185
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Country | US
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Telephone | 616-669-8880
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Fax | 616-669-2241
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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 | 2301006121
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License Number State | MI
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