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Individual

LISA MARIE VERMEULEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
4535 3 MILE RD NE, GRAND RAPIDS, MI 49525-9331
(616) 551-5433
(616) 301-2630
Mailing address
4535 3 MILE RD NE, GRAND RAPIDS, MI 49525-9331
(616) 551-5433
(616) 301-2630

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009195
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11668114
CAQH PROVIDER ID
MI
Enumeration date
01/04/2007
Last updated
11/16/2012
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