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Organization
WARNER DE LEEUW IV, PC
Active
Organization
WARNER DE LEEUW IV, PC
Active
Other names
American Chiropractic Center PC
Organization subpart
No
Provider details
NPI number
Authorized official
WARNER DE LEEUW IV DC (CHIROPRACTOR/OWNER)
(616) 243-1444
Entity
Organization
Contact information
Practice address
738 32ND ST SE, GRAND RAPIDS, MI 49548-2329
(616) 243-1444
(616) 243-2434
Mailing address
738 32ND ST SE, GRAND RAPIDS, MI 49548-2329
(616) 243-1444
(616) 243-2434
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009355
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P57110
MEDICARE PTAN
—
Enumeration date
03/06/2008
Last updated
12/09/2013
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