Jungblut Chiropractic Clinic, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

JUNGBLUT CHIROPRACTIC CLINIC, P.C.

Doing business as

Southshore Wellness Center

Practice address

549 W 18TH St
Holland, MI 49423-3962

Phone

(616) 396-7714

Fax

(616) 396-2967

NPI assigned

Mar 8, 2006

Last updated

Jul 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carl Joseph Jungblut, D.C

Title

President

Phone

(616) 396-7714

Specialties & licenses 1

Addresses

Other names 1

• Southshore Wellness Center Doing business as

Locations

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1629046610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 W 18TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233962",
            "telephone_number": "616-396-7714",
            "fax_number": "616-396-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 W 18TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233962",
            "telephone_number": "616-396-7714",
            "fax_number": "616-396-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNGBLUT CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "JUNGBLUT",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-396-7714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southshore Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Madeline Rose Jurecic, RDH
• Kathryn Ann Kabelman, PA-C
• Benjamin Steven Kadau
• Rebecca Kalkman, MA, LLP

• Chiropractor in Holland, MI
• Providers in Holland, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.