Provider Demographics
NPI:1548651086
Name:NIKKI LECLAIR
Entity type:Organization
Organization Name:NIKKI LECLAIR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-362-8991
Mailing Address - Street 1:432 W M 55
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-9239
Mailing Address - Country:US
Mailing Address - Phone:989-362-8991
Mailing Address - Fax:989-362-6237
Practice Address - Street 1:432 W M 55
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9239
Practice Address - Country:US
Practice Address - Phone:989-362-8991
Practice Address - Fax:989-362-6237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty