STANDALE CHIROPRACTIC PC (NPI# 1922301274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922301274 |
| Entity Type | Organization |
| Organization Name | STANDALE CHIROPRACTIC PC |
| Practice Address |
4110 Lake Michigan Dr Nw Grand Rapids MI 49534-4527 |
| Mailing Address |
4310 Leonard St Nw Suite 103 Walker MI 49534-8447 |
| Practice Telephone | 6164533404 |
| Practice Fax Number | 6164533418 |
| Mailing Telephone | 6164536329 |
| Mailing Fax Number | 6164531725 |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2014-01-28 |
| Authorized Official Name | DR. BRANDON J BERG (PHYSICIAN) |
| Authorized Official Telephone | 6164533404 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 2301009732 | MI | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
4110 LAKE MICHIGAN DR NW |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49534-4527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639196603 | David Robert Felton | Chiropractor | 4110 Lake Michigan Dr Nw, Grand Rapids, MI 49534 | 2006-07-16 |
| 1407165657 | Brandon J Berg | Chiropractor | 4110 Lake Michigan Dr Nw, Grand Rapids, MI 49534-4527 | 2010-10-05 |
| 1033423926 | Kb Chiropractic Pllc | Chiropractor | 4110 Lake Michigan Dr Nw, Grand Rapids, MI 49534-4527 | 2010-08-03 |
| 1447377171 | David R Felton | Chiropractor | 4110 Lake Michigan Dr Nw, Grand Rapids, MI 49534-4527 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336792324 | Heather Duthler | Social Worker | 648 Kinney Ave Nw, Grand Rapids, MI 49534 | 2019-07-19 |
| 1114473550 | Tari Kruzel | Registered Nurse | 12955 3rd Ave Nw, Grand Rapids, MI 49534 | 2016-08-26 |
| 1972847184 | Indian Trails Camp, Inc. | Day Training, Developmentally Disabled Services | O-1859 Lake Michigan Dr. Nw, Grand Rapids, MI 49534 | 2012-11-15 |
| 1871743815 | Michael Robert Anderson Jr. | Chiropractor | 0-705 Tallmadge Woods Dr. Nw, Suite A, Grand Rapids, MI 49534 | 2008-09-26 |
| 1750459285 | Rick David Saier | Internal Medicine | 1175 Wilson Ave, Walker, MI 49534 | 2006-12-01 |
| 1154414886 | Edward D Young Dds PC | Dentist | 4310 Leonard Nw, Grand Rapids, MI 49534 | 2006-10-02 |
| 1558461756 | Sandra Staublin | Pediatrics | 4288 3 Mile Road, Walker, MI 49534 | 2006-09-25 |
| 1700986999 | Belinda Chou | Pediatrics | 4288 Three Mile Road, Walker, MI 49534 | 2006-09-25 |
| 1952349235 | Chiropractic Plus, P.C. | Chiropractor | 0 699 Tallmadge Wds Nw, Suite B, Grand Rapids, MI 49534 | 2006-06-02 |
| 1326351156 | Quratul A Aziz | Internal Medicine | 1175 Wilson Ave Nw, Walker, MI 49534 | 2010-07-21 |
| Find all providers in zip 49534 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114532835 | Pro-active Chiropractic Wellness of Grand Rapids | Chiropractor | 4270 Plainfield Ave Ne # E, Grand Rapids, MI 49525-1603 | 2020-09-10 |
| 1942823695 | Seth Andrew Leali | Chiropractor | 610 Maryland Ave Ne Ste B, Grand Rapids, MI 49505-6052 | 2020-05-28 |
| 1043833213 | Christopher Carl Netley | Chiropractor | 2020 Raybrook St Se Ste 204-d, Grand Rapids, MI 49546-7717 | 2020-05-22 |
| 1477185312 | 100 Percent Chiropractic Santos, LLC | Chiropractor | 2321 E Beltline Ave Ne Ste D, Grand Rapids, MI 49525-9803 | 2020-02-09 |
| 1164087052 | Zachary David Nelson | Chiropractor | 11279 Tallmadge Woods Dr Nw, Grand Rapids, MI 49534-6318 | 2019-05-06 |
| 1760959084 | Charles Justin Austin | Chiropractor | 2504 Ardmore St Se, Grand Rapids, MI 49506-4901 | 2018-10-24 |
| 1568959211 | Northside Chiropractic LLC | Chiropractor | 2221 Plainfield Ave Ne Ste 109, Grand Rapids, MI 49505-4215 | 2018-04-18 |
| 1831694983 | Connor Wade Knapp | Chiropractor | 6807 Cascade Rd Se Ste D, Grand Rapids, MI 49546-8722 | 2018-03-29 |
| 1528587524 | Melissa Thomas | Chiropractor | 4150 E Beltline Ave Ne Ste 3, Grand Rapids, MI 49525-9316 | 2017-09-12 |
| 1619497336 | Safina Ngandu | Chiropractor | 2180 44th St Se Ste 209, Grand Rapids, MI 49508-5305 | 2017-06-23 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49534 |
Please comment or provide details below to improve the information on STANDALE CHIROPRACTIC PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.