Provider Demographics
NPI:1508131723
Name:CHOMIC, JEANETTE (DC)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:CHOMIC
Suffix:
Gender:F
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:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:HOWARD CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49329-0688
Mailing Address - Country:US
Mailing Address - Phone:231-629-1424
Mailing Address - Fax:231-648-6263
Practice Address - Street 1:837 W SHAW ST
Practice Address - Street 2:
Practice Address - City:HOWARD CITY
Practice Address - State:MI
Practice Address - Zip Code:49329-8752
Practice Address - Country:US
Practice Address - Phone:231-937-9370
Practice Address - Fax:231-648-6263
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor