J P Lasich Chiropractic, LLC
Organization Active NPI Chiropractor · Ishpeming, MI
NPI 1326587338 · NPPES record last updated Feb 23, 2017
Key facts
- NPI
- 1326587338
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- J P LASICH CHIROPRACTIC, LLC
- Practice address
- 1000 Country LN
Suite 250
Ishpeming, MI 49849-3406 - Phone
- (906) 486-2000
- Fax
- (906) 486-1298
- NPI assigned
- Feb 23, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. John Paul Lasich, D.C.
- Title
- Sole Member/Owner
- Phone
- (906) 486-2000
Practitioners 8
-
John Paul Lasich, D.C.
-
Justin Bosten, BCSI, LMT
-
Danielle Brandenburg, LMT
-
Raymond Leonard Coleman, D.C.
-
Kari Lynnette Farkas, LMT
-
Mary Elizabeth Petaisto, MASSAGE THERAPIST
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170222002968 | MI | Part B Supplier - Clinic/Group Practice | 7214211044 |
Receives reassigned benefits from 1 practitioner Practice locations: Ishpeming, MI |
National Provider Directory
Locations
1000 Country Ln
Ste 400
Ishpeming, MI 49849
Phone (906) 486-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
1000 Country LN
Suite 250
Ishpeming, MI 49849-3406
Mailing address
1000 Country LN
Suite 250
Ishpeming, MI 49849-3406
Phone (906) 486-2000
Other names
- lasich chiropractic and massage, llc
Other providers in Ishpeming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.