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MARGO IRENE FAIRBANKS D.C.

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1285782052

Individual Registrant:
 MARGO IRENE FAIRBANKS D.C.
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

Contact information for business:
510 S 9TH ST  GLADSTONE, MI 49837-1613 US
Tel: 906-428-1679  Fax: 906-428-1679

Registration Information:
NPI: 1285782052
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
MI2301005094

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
INDIVIDUAL BCBS #950B15001MI01
4356190MI05




HEALTH CARE JOBS MI - Page 1



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