Provider Demographics
NPI:1952349235
Name:CHIROPRACTIC PLUS, P.C.
Entity type:Organization
Organization Name:CHIROPRACTIC PLUS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:OHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-791-9702
Mailing Address - Street 1:0 699 TALLMADGE WDS NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534
Mailing Address - Country:US
Mailing Address - Phone:616-791-9702
Mailing Address - Fax:616-791-4661
Practice Address - Street 1:0 699 TALLMADGE WDS NW
Practice Address - Street 2:SUITE B
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49534
Practice Address - Country:US
Practice Address - Phone:616-791-9702
Practice Address - Fax:616-791-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004871111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D15118OtherBLUE CROSS BLUE SHIELD
MI0P32480Medicare PIN