Provider Demographics
NPI:1235451006
Name:LASSEIGNE, JARED JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:JAMES
Last Name:LASSEIGNE
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 1:6430 FOUNTAIN PARK CT
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1796
Mailing Address - Country:US
Mailing Address - Phone:248-396-9713
Mailing Address - Fax:
Practice Address - Street 1:7020 GATEWAY PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2574
Practice Address - Country:US
Practice Address - Phone:248-212-7435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008615111N00000X
LA1663111N00000X
MI2301010123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor