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MARGO IRENE FAIRBANKS D.C.
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1285782052
Individual Registrant: MARGO IRENE FAIRBANKS D.C.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
510 S 9TH ST GLADSTONE, MI 49837-1613 US
Tel: 906-428-1679 Fax: 906-428-1679
Tel: 906-428-1679 Fax: 906-428-1679
Contact information for business:
510 S 9TH ST GLADSTONE, MI 49837-1613 US
Tel: 906-428-1679 Fax: 906-428-1679
Tel: 906-428-1679 Fax: 906-428-1679
Registration Information:
NPI: 1285782052
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | MI | 2301005094 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| INDIVIDUAL BCBS # | 950B15001 | MI | 01 |
| 4356190 | MI | 05 |
