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NPI Code Detail

MEDICARE: DR. LEONARD HARRY NIENHUIS DC

MEDICARE: DR. LEONARD HARRY NIENHUIS DC
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
1111N00000XChiropractorLN003038MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1950G05036OTHERMIBLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1437133865
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEONARD HARRY NIENHUIS DC
Provider Business Mailing Address
First Line : 7579 MAIN ST
Second Line :
City : JENISON
State : MI
Zip : 49428-9251
Country : US
Telephone Number : 616-457-4511
Fax Number : 616-667-1936
Provider Business Practice Location Address
First Line : 7579 MAIN ST
Second Line :
City : JENISON
State : MI
Zip : 49428-9251
Country : US
Telephone Number : 616-457-4511
Fax Number : 616-667-1936
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 04/09/2008

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