Provider Demographics
NPI:1205920170
Name:GRASMAN, LISA K (DC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:K
Last Name:GRASMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2801 E PALMER WASILLA HWY
Mailing Address - Street 2:STE C
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7339
Mailing Address - Country:US
Mailing Address - Phone:907-357-3577
Mailing Address - Fax:907-357-3580
Practice Address - Street 1:2801 E PALMER WASILLA HWY
Practice Address - Street 2:STE C
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7339
Practice Address - Country:US
Practice Address - Phone:907-357-3577
Practice Address - Fax:907-357-3580
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29782111N00000X
AZ7919111N00000X
MI2301008898111N00000X
WACH60050318111N00000X
AKAK590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor