Individual
DR. ADAM RUSSELL FASICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3220 E GRAND RIVER AVE, HOWELL, MI 48843-8563
(517) 376-6836
(517) 376-6862
Mailing address
3220 E GRAND RIVER AVE, HOWELL, MI 48843-8563
(517) 376-6836
(517) 376-6862
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
AF008301
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235168121
—
MI
01
—
138952
PREFERRED CHOICES PPO ID
MI
01
—
200334885
PPOM ID
MI
01
—
950D710500
BCBS ID
MI
Enumeration date
07/02/2006
Last updated
10/18/2023
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