Provider Demographics
NPI:1619185170
Name:HASSINGER, ROYANN MARIE (D C)
Entity Type:Individual
Prefix:DR
First Name:ROYANN
Middle Name:MARIE
Last Name:HASSINGER
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-8530
Mailing Address - Country:US
Mailing Address - Phone:248-627-2908
Mailing Address - Fax:248-627-9441
Practice Address - Street 1:85 SOUTH ST
Practice Address - Street 2:
Practice Address - City:ORTONVILLE
Practice Address - State:MI
Practice Address - Zip Code:48462-8530
Practice Address - Country:US
Practice Address - Phone:248-627-2908
Practice Address - Fax:248-627-9441
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950-F-35295OtherBCBS OF MI
MI0F35295Medicare ID - Type Unspecified