Provider Demographics
NPI:1386893410
Name:LEBEL CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:LEBEL CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-271-1020
Mailing Address - Street 1:2141 BOSTON RD STE L
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1147
Mailing Address - Country:US
Mailing Address - Phone:413-271-1020
Mailing Address - Fax:413-271-1023
Practice Address - Street 1:2141 BOSTON RD STE L
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1147
Practice Address - Country:US
Practice Address - Phone:413-271-1020
Practice Address - Fax:413-271-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0008690Medicare PIN