Individual
DR. DOUGLAS GENE MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3138 BROADMOOR AVE SE, KENTWOOD, MI 49512-1845
(616) 241-4040
(616) 475-6953
Mailing address
3138 BROADMOOR AVE SE, KENTWOOD, MI 49512-1845
(616) 241-4040
(616) 475-6953
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008451
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DM008451
BLUE CROSS BLUE SHIELD
MI
Enumeration date
04/04/2007
Last updated
07/08/2007
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