Provider Demographics
NPI:1851052716
Name:GEIGER, KONNOR LYN (DC)
Entity Type:Individual
Prefix:
First Name:KONNOR
Middle Name:LYN
Last Name:GEIGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 KEIM RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48815-9758
Mailing Address - Country:US
Mailing Address - Phone:616-430-8102
Mailing Address - Fax:
Practice Address - Street 1:13105 SCHAVEY RD STE 6
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-9039
Practice Address - Country:US
Practice Address - Phone:517-668-6215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor