Provider Demographics
NPI:1831251354
Name:LEGASEA CHIROPRACTIC PROF. LLC
Entity type:Organization
Organization Name:LEGASEA CHIROPRACTIC PROF. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-361-6706
Mailing Address - Street 1:2523 S SHIRLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4324
Mailing Address - Country:US
Mailing Address - Phone:605-361-6706
Mailing Address - Fax:
Practice Address - Street 1:116 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:SD
Practice Address - Zip Code:57349
Practice Address - Country:US
Practice Address - Phone:605-772-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty