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14050 Fruit Ridge Ave, Kent City, MI 49330-8922 | |
(616) 378-5538 | |
(616) 399-4491 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 14050 Fruit Ridge Ave, Kent City, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770644932 | NPI | - | NPPES |
4873635 TYPE 14 | Medicaid | MI | |
11553234 | Other | MI | CAQH |
95-0D11579-0 | Other | MI | BCBS |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 2301009144 (Michigan) | Primary |
Provider Name | Jeremy Reister |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1417927427 PECOS PAC ID: 6406862697 Enrollment ID: I20060224000532 |
Mailing Address | Practice Location Address |
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4310 Leonard St Nw., Suite 103, Walker, MI 49534-8447 Ph: (616) 453-6329 | 14050 Fruit Ridge Ave, Kent City, MI 49330-8922 Ph: (616) 378-5538 |
Dr. Jeremy S Reister, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 14050 Fruit Ridge Ave, Kent City, MI 49330 Phone: 616-378-5538 Fax: 616-399-4491 |