Provider Demographics
NPI:1548983463
Name:MEGAN HOTRUM DC PLLC
Entity type:Organization
Organization Name:MEGAN HOTRUM DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HOTRUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-924-6362
Mailing Address - Street 1:1344 MOCCASIN TRL
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-4241
Mailing Address - Country:US
Mailing Address - Phone:269-924-6362
Mailing Address - Fax:
Practice Address - Street 1:9555 COMMERCE RD STE 1
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-4165
Practice Address - Country:US
Practice Address - Phone:269-924-6362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty