Provider Demographics
NPI:1437459054
Name:CHAPPELL-LAKIN, MARK EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:CHAPPELL-LAKIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:MARK
Other - Middle Name:EDWARD
Other - Last Name:LAKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:413 MARK HANNAH PL
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:204 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2008
Practice Address - Country:US
Practice Address - Phone:734-546-4036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor