Provider Demographics
NPI:1750676409
Name:CLEAR CONNECTIONS CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:CLEAR CONNECTIONS CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CZEGUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-255-2772
Mailing Address - Street 1:1500 E BELTLINE AVE SE
Mailing Address - Street 2:SUITE 145
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4361
Mailing Address - Country:US
Mailing Address - Phone:616-608-3606
Mailing Address - Fax:616-551-3233
Practice Address - Street 1:1500 E BELTLINE AVE SE
Practice Address - Street 2:SUITE 145
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-4361
Practice Address - Country:US
Practice Address - Phone:616-608-3606
Practice Address - Fax:616-551-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty