Provider Demographics
NPI:1558361253
Name:RASSEL, DENISE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ANN
Last Name:RASSEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 N CLIPPERT ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-4740
Mailing Address - Country:US
Mailing Address - Phone:517-203-2090
Mailing Address - Fax:517-203-2092
Practice Address - Street 1:537 N CLIPPERT ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4740
Practice Address - Country:US
Practice Address - Phone:517-203-2090
Practice Address - Fax:517-203-2092
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4218031Medicaid
U82354Medicare UPIN
MI4218031Medicaid