Fairbanks, Russell Austin
Fairbanks, Russell Austin is an individual health care provider with primary practice located at 408 N Third St , Rogers City MI 49779-1309. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Fairbanks, Russell Austin can be contacted via phone (989) 734-3384.Contact Information
Primary practice address
408 N Third St
Rogers City MI 49779-1309
Phone: (989) 734-3384
Fax: (989) 734-7391
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2301005062 | Michigan |
Profile Details
| NPI number | 1528018355 |
|---|---|
| LBN Legal business name | Fairbanks, Russell Austin |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2006 |
| Last updated | Jun 14th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528018355 | NPPES |
| Michigan | MEDICAID | 2967204 | |
| Michigan | Other | 95OG150000 |
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