Provider Demographics
NPI:1114532835
Name:BEAR CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:BEAR CHIROPRACTIC CORPORATION
Other - Org Name:BEAR CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-228-4189
Mailing Address - Street 1:4270 PLAINFIELD AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-1603
Mailing Address - Country:US
Mailing Address - Phone:616-228-4189
Mailing Address - Fax:616-317-7071
Practice Address - Street 1:4270 PLAINFIELD AVE NE # E
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1603
Practice Address - Country:US
Practice Address - Phone:616-228-4189
Practice Address - Fax:616-288-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1306302864OtherNPI 1