Provider Demographics
NPI:1265671606
Name:SEMLOW, KIRK JUSTIN (DC)
Entity Type:Individual
Prefix:MR
First Name:KIRK
Middle Name:JUSTIN
Last Name:SEMLOW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S. BEECHTREE ST.
Mailing Address - Street 2:STE A
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2072
Mailing Address - Country:US
Mailing Address - Phone:616-846-5000
Mailing Address - Fax:616-846-5002
Practice Address - Street 1:302 S. BEECHTREE ST.
Practice Address - Street 2:STE A
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2072
Practice Address - Country:US
Practice Address - Phone:616-846-5000
Practice Address - Fax:616-846-5002
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor