1831212430 NPI number — POSITIVE DIRECTIONS WELLNESS CENTER

Table of content: DR. BRITTANY JENKINS ZIEGLER DPT (NPI 1871255802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831212430 NPI number — POSITIVE DIRECTIONS WELLNESS CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POSITIVE DIRECTIONS WELLNESS CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831212430
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
327 N RIVER AVE
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
HOLLAND
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49424-2180
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-994-6801
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
327 N RIVER AVE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
HOLLAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49424-2180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-994-6801
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BORR
Authorized Official First Name:
EVORA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
MASSAGE THERAPIST
Authorized Official Telephone Number:
616-994-6801

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  CERTIFIED , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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