Provider Demographics
NPI:1780175372
Name:LEBLANC, MICHAEL S (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 E MCNEESE ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-5835
Mailing Address - Country:US
Mailing Address - Phone:337-508-2955
Mailing Address - Fax:337-508-2954
Practice Address - Street 1:943 E MCNEESE ST STE A
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-5835
Practice Address - Country:US
Practice Address - Phone:337-508-2955
Practice Address - Fax:337-508-2954
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-20
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1835111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty