Provider Demographics
NPI:1003642539
Name:VANWINKLE FAMILY CHIROPRACTIC PLC
Entity type:Organization
Organization Name:VANWINKLE FAMILY CHIROPRACTIC PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:VANWINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-986-8903
Mailing Address - Street 1:10507 S MACKINAC TRL
Mailing Address - Street 2:
Mailing Address - City:DAFTER
Mailing Address - State:MI
Mailing Address - Zip Code:49724-9550
Mailing Address - Country:US
Mailing Address - Phone:269-986-8903
Mailing Address - Fax:
Practice Address - Street 1:2963 W DICKMAN RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MI
Practice Address - Zip Code:49037-7939
Practice Address - Country:US
Practice Address - Phone:269-986-8903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR JENNIFER VANWINKLE DC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-11
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty