Individual
CHRISTOPHER MARK PASSALACQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C., L.C.P., DPHCS
Contact information
Practice address
5909 JOHN R RD, TROY, MI 48085-3867
(248) 879-5540
(248) 879-5502
Mailing address
701 INDIAN LAKE RD, OXFORD, MI 48371-6220
(248) 814-9499
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OF35270
BLUCROSSBLUESHIELD
MI
Enumeration date
07/21/2006
Last updated
07/08/2007
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