Provider Demographics
NPI:1497964761
Name:BLEGGI, NICOLA THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLA
Middle Name:THOMAS
Last Name:BLEGGI
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 1:39142 MEETING HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1002
Mailing Address - Country:US
Mailing Address - Phone:734-953-0479
Mailing Address - Fax:248-559-6228
Practice Address - Street 1:28455 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076
Practice Address - Country:US
Practice Address - Phone:248-559-6228
Practice Address - Fax:248-559-6228
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINB300307111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor