Provider Demographics
NPI:1508036120
Name:LESDC,LLC
Entity Type:Organization
Organization Name:LESDC,LLC
Other - Org Name:ERIE COAST CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SYLVESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-934-9100
Mailing Address - Street 1:36711 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011
Mailing Address - Country:US
Mailing Address - Phone:440-934-9100
Mailing Address - Fax:
Practice Address - Street 1:36711 AMERICAN WAY
Practice Address - Street 2:SUITE A
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4045
Practice Address - Country:US
Practice Address - Phone:440-934-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty