| NPI | 1396018446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C SCOTT KOOISTRA Doctor Of Chiropractic 616-532-2518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 1496) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |