Provider Demographics
NPI:1760647952
Name:LEGEL CHIROPRACTIC SVC. INC.
Entity Type:Organization
Organization Name:LEGEL CHIROPRACTIC SVC. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:LEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-261-2121
Mailing Address - Street 1:28404 FIVE MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3824
Mailing Address - Country:US
Mailing Address - Phone:734-261-2121
Mailing Address - Fax:734-261-2433
Practice Address - Street 1:28404 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3824
Practice Address - Country:US
Practice Address - Phone:734-261-2121
Practice Address - Fax:734-261-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty