Healthcare Provider Details

I. General information

NPI: 1063876837
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL SASS DC, DACNB, FABBIR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5136 CASCADE RD SE STE 1D
GRAND RAPIDS MI
49546-3728
US

IV. Provider business mailing address

5136 CASCADE RD SE STE 1D
GRAND RAPIDS MI
49546-3728
US

V. Phone/Fax

Practice location:
  • Phone: 616-581-1558
  • Fax:
Mailing address:
  • Phone: 616-581-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCHIR009578
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCH11652
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCR2344
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number2301011001
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: