Provider Demographics
NPI:1497533582
Name:EASTSIDE AUTO & INJURY CHIROPRACTIC
Entity Type:Organization
Organization Name:EASTSIDE AUTO & INJURY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-208-0565
Mailing Address - Street 1:6655 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-5100
Mailing Address - Country:US
Mailing Address - Phone:520-208-0565
Mailing Address - Fax:520-322-8900
Practice Address - Street 1:6655 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-5100
Practice Address - Country:US
Practice Address - Phone:520-208-0565
Practice Address - Fax:520-322-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty