Provider Demographics
NPI:1861676918
Name:ANNEMARIE FILISKY LECLAIR
Entity Type:Organization
Organization Name:ANNEMARIE FILISKY LECLAIR
Other - Org Name:LECLAIR FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILISKY LECLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-835-7414
Mailing Address - Street 1:3704 W EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8725
Mailing Address - Country:US
Mailing Address - Phone:813-835-7414
Mailing Address - Fax:813-832-2932
Practice Address - Street 1:3704 W EUCLID AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8725
Practice Address - Country:US
Practice Address - Phone:813-835-7414
Practice Address - Fax:813-832-2932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV03175Medicare UPIN