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A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Chiropractor |
111N00000X | 35 | Chiropractic | |
Physical Therapist |
225100000X | 65 | Physical Therapist in Private Practice |
| NPI Number | 1114116522 |
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| LBN Legal business name | RAVENSWOOD HEALTH CENTER, P.C. | ||||||||
| Authorized official | JASON FENNEMA - (OWNER/PRESIDENT) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 10/22/2007 | ||||||||
| Last updated | 12/30/2014 - About 11 years ago | ||||||||
| Identifiers |
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RAVENSWOOD HEALTH CENTER, P.C.
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RAVENSWOOD HEALTH CENTER, P.C.