Provider Demographics
NPI:1417754987
Name:SCLABASSI, MARC WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:WILLIAM
Last Name:SCLABASSI
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39680 W 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3909
Mailing Address - Country:US
Mailing Address - Phone:248-960-8828
Mailing Address - Fax:248-960-8829
Practice Address - Street 1:39680 W 14 MILE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3909
Practice Address - Country:US
Practice Address - Phone:248-960-8828
Practice Address - Fax:248-960-8829
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor