Provider Demographics
NPI:1871851337
Name:SARVER CHIROPRACTIC PC
Entity type:Organization
Organization Name:SARVER CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SARVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-949-3300
Mailing Address - Street 1:723 KENMOOR AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2370
Mailing Address - Country:US
Mailing Address - Phone:616-949-3300
Mailing Address - Fax:616-956-5519
Practice Address - Street 1:723 KENMOOR AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2370
Practice Address - Country:US
Practice Address - Phone:616-949-3300
Practice Address - Fax:616-956-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005689111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty