Provider Demographics
NPI:1487296760
Name:INSPIRED HEALTH & WELLNESS PLLC
Entity type:Organization
Organization Name:INSPIRED HEALTH & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-459-1272
Mailing Address - Street 1:4415 DUKE ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3224
Mailing Address - Country:US
Mailing Address - Phone:269-459-1272
Mailing Address - Fax:269-459-1271
Practice Address - Street 1:4415 DUKE ST STE 2E
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3224
Practice Address - Country:US
Practice Address - Phone:269-459-1272
Practice Address - Fax:269-459-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301075633OtherSTATE OF MICHIGAN