Provider Demographics
NPI:1790395093
Name:LEVAN CHIROPRACTIC
Entity Type:Organization
Organization Name:LEVAN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:LEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-571-2521
Mailing Address - Street 1:6650 LEWIS AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-1201
Mailing Address - Country:US
Mailing Address - Phone:717-571-2521
Mailing Address - Fax:
Practice Address - Street 1:6650 LEWIS AVE STE 11
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-1201
Practice Address - Country:US
Practice Address - Phone:717-571-2252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty