Provider Demographics
NPI:1538412036
Name:DONNELL, CALEB (DC)
Entity type:Individual
Prefix:DR
First Name:CALEB
Middle Name:
Last Name:DONNELL
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 1:1230 COLUMBIA AVE E
Mailing Address - Street 2:A
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5188
Mailing Address - Country:US
Mailing Address - Phone:269-964-1441
Mailing Address - Fax:269-964-0137
Practice Address - Street 1:5080 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1099
Practice Address - Country:US
Practice Address - Phone:269-459-1339
Practice Address - Fax:269-456-1340
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor