Provider Demographics
NPI:1912284555
Name:STEENSTRA, JESSICA SUSAN (DC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:SUSAN
Last Name:STEENSTRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:SUSAN
Other - Last Name:IRELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:25 N. 68TH AVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:COOPERSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49404
Mailing Address - Country:US
Mailing Address - Phone:616-997-1938
Mailing Address - Fax:
Practice Address - Street 1:25 N. 68TH AVE
Practice Address - Street 2:SUITE J
Practice Address - City:COOPERSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49404
Practice Address - Country:US
Practice Address - Phone:616-997-1938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor