Provider Demographics
NPI:1356451454
Name:LECLAIR, BRETT MICHAEL (DC)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:MICHAEL
Last Name:LECLAIR
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:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-0589
Mailing Address - Country:US
Mailing Address - Phone:603-929-9255
Mailing Address - Fax:603-457-6027
Practice Address - Street 1:239 DRAKSIDE RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842
Practice Address - Country:US
Practice Address - Phone:603-929-9255
Practice Address - Fax:603-457-6027
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2271095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
648529OtherAMERICAN CHIROPRACTIC NET
352257OtherHARVARD PILGRIM HEALTH
NH71095OtherLANDMARK HEALTHCARE
0835755OtherCIGNA HEALTH SOURCE
352257OtherHARVARD PILGRIM HEALTH