Provider Demographics
NPI:1467419515
Name:FALK, BRIAN F (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:F
Last Name:FALK
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 1:6004 TORREY RD
Mailing Address - Street 2:STE K
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3800
Mailing Address - Country:US
Mailing Address - Phone:810-655-2666
Mailing Address - Fax:810-655-2834
Practice Address - Street 1:6004 TORREY RD
Practice Address - Street 2:F
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3800
Practice Address - Country:US
Practice Address - Phone:810-655-2666
Practice Address - Fax:810-655-2834
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950B551090OtherBCBS
MI144382412Medicaid
MI350050605OtherMEDICARE/RAILROAD
MI350050605OtherMEDICARE/RAILROAD
MIT32775Medicare UPIN