Organization
JS REISTER DC PLLC
Active
Other names
Reister Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY S REISTER DC (PHYSICIAN)
(616) 378-5538
Entity
Organization
Contact information
Practice address
14050 FRUIT RIDGE AVE, KENT CITY, MI 49330-8922
(616) 378-5538
(616) 399-4491
Mailing address
4310 LEONARD ST NW., SUITE 103, WALKER, MI 49534-8447
(616) 453-6329
(616) 453-1725
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009144
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11553234
CAQH
MI
05
—
4873635 TYPE 14
—
MI
01
—
95-0D11579-0
BCBS
MI
Enumeration date
12/12/2006
Last updated
04/27/2016
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