Individual
JESSE LYNN FASICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 HALL ST UNIT A, TRAVERSE CITY, MI 49684-2288
(231) 922-4850
Mailing address
14693 CINDER RD, BEULAH, MI 49617-9367
(231) 633-6133
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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