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Organization

GEORGETOWN CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEONARD H NIENHUIS D.C. (PARTNER)
(616) 457-4511
Entity
Organization

Contact information

Practice address
7579 MAIN ST, JENISON, MI 49428-9251
(616) 457-4511
(616) 667-1936
Mailing address
7579 MAIN ST, JENISON, MI 49428-9251
(616) 457-4511
(616) 667-1936

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0G05036
MEDICARE PLUS BLUE
MI
01
959G01031
BC ID NUMBER
MI
01
DG7550
RAILROAD MEDICARE
MI
Enumeration date
03/05/2007
Last updated
04/09/2008
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