Organization Name: | INNATE HEALTH |
NPI Number: | 1003259813 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUSTIN KEFFER (PRESIDENT/CHIROPRACTOR) |
Mailing Address: | 6735 Cascade Rd Se Suite 200 Grand Rapids |
State: | MI US |
Postal Code: | 495466887 |
Phone Number: | 6162955699 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2013 |
NPI Last Update Date: | 08/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111NT0100X |
License Number: | 2301010075 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | Thermography |
Taxonomy Definition: |