Provider Demographics
NPI:1700027687
Name:CHIROFIT
Entity Type:Organization
Organization Name:CHIROFIT
Other - Org Name:THE CHIROFIT WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RADEMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-458-2348
Mailing Address - Street 1:2249 WEALTHY ST SE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-3052
Mailing Address - Country:US
Mailing Address - Phone:616-458-2348
Mailing Address - Fax:616-458-2342
Practice Address - Street 1:2249 WEALTHY ST SE
Practice Address - Street 2:SUITE 240
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-3052
Practice Address - Country:US
Practice Address - Phone:616-458-2348
Practice Address - Fax:616-458-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009386111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty