Provider Demographics
NPI:1457413874
Name:RESSLER, JOHN GARY (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GARY
Last Name:RESSLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3093 BROADMOOR AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-1877
Mailing Address - Country:US
Mailing Address - Phone:616-956-9060
Mailing Address - Fax:
Practice Address - Street 1:3093 BROADMOOR AVE SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-1877
Practice Address - Country:US
Practice Address - Phone:616-956-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor