Provider Demographics
NPI:1356975775
Name:KALAMAZOO CHIROPRACTIC & REHABILITATION
Entity type:Organization
Organization Name:KALAMAZOO CHIROPRACTIC & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-291-8148
Mailing Address - Street 1:3275 COOLEY CT STE 150
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-7432
Mailing Address - Country:US
Mailing Address - Phone:269-202-8251
Mailing Address - Fax:
Practice Address - Street 1:3275 COOLEY CT STE 150
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-7432
Practice Address - Country:US
Practice Address - Phone:269-202-8251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty