Provider Demographics
NPI:1720331887
Name:DEMEESTER, MARC ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ANDREW
Last Name:DEMEESTER
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 1:209 BLISS DR SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-2108
Mailing Address - Country:US
Mailing Address - Phone:303-601-3820
Mailing Address - Fax:
Practice Address - Street 1:209 BLISS DR SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2108
Practice Address - Country:US
Practice Address - Phone:303-601-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6367111N00000X, 111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NT0100XChiropractic ProvidersChiropractorThermography