# GRAND RAPIDS APPLIED KINESIOLOGY AND SPORTS CHIROPRACTIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972909794
- **Authorized official:** DR. SHANE PLUGER (CHIROPRACTOR)
- **Authorized official phone:** (616) 916-4767

## Contact information

- **Practice address:** 3835 28TH ST SE, STE 102, GRAND RAPIDS, MI 49512-1876
- **Practice address phone:** (616) 916-4767
- **Mailing address:** 3835 28TH ST SE, STE 102, GRAND RAPIDS, MI 49512-1876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 3644880 | MI | Yes |

## Other

- **Enumeration date:** 11/05/2014
- **Last updated:** 11/05/2014