Provider Demographics
NPI:1932405164
Name:LEGAULT, STEVEN K (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:K
Last Name:LEGAULT
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 1:120 THREE DEGREE RD STE C
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2304
Mailing Address - Country:US
Mailing Address - Phone:412-364-4100
Mailing Address - Fax:412-837-8008
Practice Address - Street 1:120 THREE DEGREE RD STE C
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2304
Practice Address - Country:US
Practice Address - Phone:412-364-4100
Practice Address - Fax:412-837-8008
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-05
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1038520430001Medicaid