Provider Demographics
NPI:1073916052
Name:LESSARD, SCOTT R (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:LESSARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1682 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4363
Mailing Address - Country:US
Mailing Address - Phone:925-273-9750
Mailing Address - Fax:925-273-7021
Practice Address - Street 1:1682 FIRST ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4363
Practice Address - Country:US
Practice Address - Phone:925-273-9750
Practice Address - Fax:925-273-7021
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor