Provider Demographics
NPI:1326198417
Name:HEALTHZONE CHIROPRACTIC 5 PC
Entity Type:Organization
Organization Name:HEALTHZONE CHIROPRACTIC 5 PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-913-8852
Mailing Address - Street 1:1207 S BEECHTREE ST
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2839
Mailing Address - Country:US
Mailing Address - Phone:616-846-4689
Mailing Address - Fax:616-844-0687
Practice Address - Street 1:1207 S BEECHTREE ST
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2839
Practice Address - Country:US
Practice Address - Phone:616-846-4689
Practice Address - Fax:616-844-0687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty