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General NPI Number Information
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NPI Number | 1982963161
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Entity Type | Individual
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Provider Name | LANCE CHARLES ZUIDEMA D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 36 44TH ST SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-2177
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Country | US
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Telephone | 616-457-9900
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Fax | 616-457-9910
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Provider Business Mailing Address
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Address Line | 36 44TH ST SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-2177
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Country | US
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Telephone | 616-457-5700
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Fax | 616-457-1795
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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 | 2301009887
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License Number State | MI
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