Provider Demographics
NPI:1972077113
Name:HOMETOWN CHIROPRACTIC SPRING ARBOR, PLLC
Entity type:Organization
Organization Name:HOMETOWN CHIROPRACTIC SPRING ARBOR, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:BIELSKI
Authorized Official - Last Name:DERSCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-795-2775
Mailing Address - Street 1:1408 LEROY ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3542
Mailing Address - Country:US
Mailing Address - Phone:517-795-2775
Mailing Address - Fax:517-796-3119
Practice Address - Street 1:215 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9673
Practice Address - Country:US
Practice Address - Phone:517-795-2775
Practice Address - Fax:517-796-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty