Provider Demographics
NPI:1619006863
Name:LEONARD H. NIENHUIS D.C. P.C.
Entity Type:Organization
Organization Name:LEONARD H. NIENHUIS D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:NIENHUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-457-4511
Mailing Address - Street 1:7579 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-9251
Mailing Address - Country:US
Mailing Address - Phone:616-457-4511
Mailing Address - Fax:616-667-1936
Practice Address - Street 1:7579 MAIN ST
Practice Address - Street 2:
Practice Address - City:JENISON
Practice Address - State:MI
Practice Address - Zip Code:49428-9251
Practice Address - Country:US
Practice Address - Phone:616-457-4511
Practice Address - Fax:616-667-1936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty