Dr. Tyler Jeffrey Vanderwal, DC
Chiropractor in Caledonia, MI. Individual provider (NPI-1).
NPI number1669972188
StatusActive
Last updated in NPPESFeb 21, 2018
Details
- NPI
- 1669972188
- Entity type
- Individual (NPI-1)
- Name
- Dr. Tyler Jeffrey Vanderwal
- Credential
- DC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2018
- Last updated
- Feb 21, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CHIROPRACTIC
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 2301010630 | MI | Yes |
Practice location
649 Emmons St SeCaledonia, MI 49316-8316
Phone 616-891-8153 · Fax 616-891-8153
Mailing address
2061 Ridgecrest Rd Se Apt 6Grand Rapids, MI 49546-4373
Phone 616-350-7313
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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