Provider Demographics
NPI:1518218650
Name:LASICH, JOHN PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:LASICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1000 COUNTRY LN
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-3406
Mailing Address - Country:US
Mailing Address - Phone:906-486-2000
Mailing Address - Fax:906-486-1298
Practice Address - Street 1:1000 COUNTRY LN
Practice Address - Street 2:SUITE 250
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-3406
Practice Address - Country:US
Practice Address - Phone:906-486-2000
Practice Address - Fax:906-486-1298
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI2301010020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor