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NPI Code Detail

MEDICARE: LISA BRUNETTE

MEDICARE: LISA BRUNETTE
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
1111N00000XChiropractor2301401656MI

General Provider Information

NPI Number : 1558241109
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA BRUNETTE
Provider Business Mailing Address
First Line : 10891 2ND AVE NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49534-5892
Country : US
Telephone Number : 616-570-4647
Fax Number :
Provider Business Practice Location Address
First Line : 84 E LAKEWOOD BLVD
Second Line :
City : HOLLAND
State : MI
Zip : 49424-2000
Country : US
Telephone Number : 616-570-4647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2025
Last Update Date : 01/26/2026

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Directions to “ LISA BRUNETTE ” Practice Location

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