Provider Demographics
NPI:1700027034
Name:SEMLOW PEAK PERFORMANCE CHIROPRACTIC
Entity Type:Organization
Organization Name:SEMLOW PEAK PERFORMANCE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:SEMLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-846-5000
Mailing Address - Street 1:302 S BEECHTREE ST STE A
Mailing Address - Street 2:
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 STE A
Practice Address - Street 2:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty