Provider Demographics
NPI:1659932291
Name:DESTIN LEGACY INC
Entity Type:Organization
Organization Name:DESTIN LEGACY INC
Other - Org Name:EAST PLANO CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSTEADT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:972-424-4266
Mailing Address - Street 1:4101 E PARK BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-3409
Mailing Address - Country:US
Mailing Address - Phone:972-424-4266
Mailing Address - Fax:972-424-4266
Practice Address - Street 1:2200 LOS RIOS BLVD STE 127
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-3478
Practice Address - Country:US
Practice Address - Phone:972-424-4266
Practice Address - Fax:972-424-4266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty