Provider Demographics
NPI:1124161989
Name:LEQUIRE, EDWARD S (DC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:S
Last Name:LEQUIRE
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 1:2625 HIGHWAY 14 W
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-7597
Mailing Address - Country:US
Mailing Address - Phone:507-208-4538
Mailing Address - Fax:507-208-4539
Practice Address - Street 1:2625 HIGHWAY 14 W
Practice Address - Street 2:SUITE B
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-7597
Practice Address - Country:US
Practice Address - Phone:507-208-4538
Practice Address - Fax:507-208-4539
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5119111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor