Coopersville Chiropractic LLC
Organization Active NPI Chiropractor · Coopersville, MI
NPI 1851662571 · NPPES record last updated Jan 26, 2012
Key facts
- NPI
- 1851662571
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2301009825 (MI)
- Legal business name
- COOPERSVILLE CHIROPRACTIC LLC
- Practice address
- 25 68TH Ave N
Suite J
Coopersville, MI 49404-9223 - Phone
- (616) 997-1938
- NPI assigned
- Jan 26, 2012
- Organization subpart
- No
Authorized official
- Name
- Jessica Susan Ireland, D.C.
- Title
- Owner/Operator
- Phone
- (313) 218-1938
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120409000627 | MI | Part B Supplier - Clinic/Group Practice | 6800057464 |
Receives reassigned benefits from 1 practitioner Practice locations: Coopersville, MI |
National Provider Directory
Locations
25 68th Ave N
Ste J
Coopersville, MI 49404
Phone (616) 997-1938
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2301009825 | MI | Yes |
Addresses
Primary practice location
25 68TH Ave N
Suite J
Coopersville, MI 49404-9223
Mailing address
25 68TH Ave N
Suite J
Coopersville, MI 49404-9223
Phone (616) 997-1938
Other providers in Coopersville, MI
- Jessica Bukrey
- Julie Kristine Bukrey
- Checordra LLC
- Susan Cogswell
- Kaylie Ann Cole
- Coopersville Dental Associates Inc
- Coopersville Vision Center PC
- Kari Cottrell
- David M Shabluk DDS, PC
- Susan Dice
All providers in Coopersville, MI · Chiropractor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.