MEDICARE: DR. JOSHUA MILTON SUNDBERG D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301010202	MI

General Provider Information

NPI Number	:	1023425568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA MILTON SUNDBERG D.C.

Provider Business Mailing Address
First Line	:	4403 W MICHIGAN AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49006-5866
Country	:	US
Telephone Number	:	269-375-6565
Fax Number	:	269-375-7168

Provider Business Practice Location Address
First Line	:	4403 W MICHIGAN AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49006-5866
Country	:	US
Telephone Number	:	269-330-2381
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	10/13/2017

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