Provider Demographics
NPI:1417950676
Name:ADAM, DENNIS VAL (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:VAL
Last Name:ADAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FAIRBANKS ST
Mailing Address - Street 2:# S1
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-1510
Mailing Address - Country:US
Mailing Address - Phone:906-774-5824
Mailing Address - Fax:906-774-6349
Practice Address - Street 1:200 FAIRBANKS ST
Practice Address - Street 2:# S1
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-1510
Practice Address - Country:US
Practice Address - Phone:906-774-5824
Practice Address - Fax:906-774-6349
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI002534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38789800Medicaid
WI97150170OtherWAUSAU
MI1071660Medicaid
MI950B25006OtherBCBSM
MI1071660Medicaid