Provider Demographics
NPI:1730626466
Name:LANG, KURT (DC)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:LANG
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 1:1971 E BELTLINE AVE NE
Mailing Address - Street 2:SUITE 126
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-7045
Mailing Address - Country:US
Mailing Address - Phone:616-855-2017
Mailing Address - Fax:616-828-1904
Practice Address - Street 1:1971 E BELTLINE AVE NE
Practice Address - Street 2:SUITE 126
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7045
Practice Address - Country:US
Practice Address - Phone:616-855-2017
Practice Address - Fax:616-828-1904
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor