NPIMap

Organization Active NPI

Charles Lietz Action Ak Chiropractic Clinic LLC

  • Chiropractor
  • Grandville, MI
National Provider Identifier
1144518705
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004973 Issued in MI
Legal business name
CHARLES LIETZ ACTION AK CHIROPRACTIC CLINIC LLC
Practice address
3584 Fairlanes Ave SW
Grandville, MI 49418-1583
Phone
(616) 530-3333
Fax
(616) 608-3803
NPI assigned
Jul 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Charles Michael Lietz, D.C.NPI 1568682201
Title
Owner
Phone
(616) 530-3333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301004973 MI Primary

Addresses

Primary practice location

3584 Fairlanes Ave SW
Grandville, MI 49418-1583

Mailing address

3584 Fairlanes Ave SW
Grandville, MI 49418-1583
Phone (616) 530-3333

National Provider Directory

National Provider Directory

Locations

3584 Fairlanes Ave SW
Grandville, MI 49418
Phone (616) 222-5300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1144518705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 FAIRLANES AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181583",
            "telephone_number": "616-530-3333",
            "fax_number": "616-608-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 FAIRLANES AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181583",
            "telephone_number": "616-530-3333",
            "fax_number": "616-608-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES LIETZ ACTION AK CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "LIETZ",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-530-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.