Provider Demographics
NPI:1982944070
Name:VASSAR CHIROPRACTIC AND REHABILITATION PLC
Entity Type:Organization
Organization Name:VASSAR CHIROPRACTIC AND REHABILITATION PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-277-2257
Mailing Address - Street 1:330 KALAMAZOO ST
Mailing Address - Street 2:UNIT #3
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49090-1388
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:330 KALAMAZOO ST
Practice Address - Street 2:UNIT #3
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-1388
Practice Address - Country:US
Practice Address - Phone:269-277-2257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty