Provider Demographics
NPI:1144468588
Name:LEGERE, JOHN MARC (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARC
Last Name:LEGERE
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 1:1523 CANYON DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-4302
Mailing Address - Country:US
Mailing Address - Phone:717-490-5927
Mailing Address - Fax:
Practice Address - Street 1:357 S GULPH RD
Practice Address - Street 2:SUITE 310
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3174
Practice Address - Country:US
Practice Address - Phone:610-265-2230
Practice Address - Fax:717-397-0276
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAJ009873111N00000X
PADC010058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor