Provider Demographics
NPI:1871566943
Name:VANHOUTTEGHEM, ARTHUR J (DC)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:J
Last Name:VANHOUTTEGHEM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21231 LAKELAND ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3368
Mailing Address - Country:US
Mailing Address - Phone:586-777-7463
Mailing Address - Fax:586-777-6103
Practice Address - Street 1:21231 LAKELAND ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081
Practice Address - Country:US
Practice Address - Phone:586-777-7463
Practice Address - Fax:586-777-6103
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E05145Medicare ID - Type Unspecified