Provider Demographics
NPI:1558670406
Name:KAIZEN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KAIZEN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEEANN
Authorized Official - Last Name:HEMGREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-828-1384
Mailing Address - Street 1:231 E A ST
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-3406
Mailing Address - Country:US
Mailing Address - Phone:906-828-1384
Mailing Address - Fax:
Practice Address - Street 1:231 E A ST
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-3406
Practice Address - Country:US
Practice Address - Phone:906-828-1384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009709111N00000X
MI2301008423111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty