Provider Demographics
NPI:1942965728
Name:BACH, JORDAN L (DC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:L
Last Name:BACH
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 1:18875 E CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:CEMENT CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49233-9005
Mailing Address - Country:US
Mailing Address - Phone:517-740-5485
Mailing Address - Fax:517-800-3067
Practice Address - Street 1:18875 E CHICAGO RD
Practice Address - Street 2:
Practice Address - City:CEMENT CITY
Practice Address - State:MI
Practice Address - Zip Code:49233-9005
Practice Address - Country:US
Practice Address - Phone:517-740-5485
Practice Address - Fax:517-800-3067
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301011075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor