Individual
DR. MATT DEVREUGD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6411 BELLA VISTA DR NE, STE #2, ROCKFORD, MI 49341-7869
(616) 874-7255
(616) 874-7196
Mailing address
6411 BELLA VISTA DR NE, STE #2, ROCKFORD, MI 49341-7869
(616) 874-7255
(616) 874-7196
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009861
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F38212
BCBSM PIN
MI
01
—
0P04060
MEDICARE PTAN
MI
Enumeration date
11/23/2011
Last updated
01/14/2013
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