Provider Demographics
NPI:1427059583
Name:LASCALA, JOSEPH A (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:LASCALA
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 1:6601 LEWIS AVE.
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9106
Mailing Address - Country:US
Mailing Address - Phone:734-847-7640
Mailing Address - Fax:734-847-7486
Practice Address - Street 1:6601 LEWIS AVE.
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-9106
Practice Address - Country:US
Practice Address - Phone:734-847-7640
Practice Address - Fax:734-847-7486
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0007723115OtherAETNA
MI950E850240OtherBCBS OF MICHIGAN
MI350046286OtherRR MEDICARE
MI02956OtherPARAMOUNT
MI950E850240OtherBCBS OF MICHIGAN
MI0007723115OtherAETNA