Organization
DYKSTRA CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONDA LYNN VANDERWALL DC (DOCTOR OF CHIROPRACTIC)
(616) 531-6050
Entity
Organization
Contact information
Practice address
4072 CHICAGO DR SW, GRANDVILLE, MI 49418-1291
(616) 531-6050
(616) 531-6053
Mailing address
4072 CHICAGO DR SW, GRANDVILLE, MI 49418-1291
(616) 531-6050
(616) 531-6053
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2301008861
MI
111N00000X
Chiropractor
Primary
2301009329
MI
111N00000X
Chiropractor
2301010292
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144842737
—
MI
Enumeration date
06/21/2007
Last updated
05/08/2017
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