MEDICARE: DR. JOSEPH A. LASCALA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301007176	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	350046286	OTHER	MI	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0007723115	OTHER	MI	AETNA
2	950E850240	OTHER	MI	BCBS OF MICHIGAN
4	02956	OTHER	MI	PARAMOUNT

General Provider Information

NPI Number	:	1427059583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH A. LASCALA DC

Provider Business Mailing Address
First Line	:	6601 LEWIS AVE.
Second Line	:
City	:	TEMPERANCE
State	:	MI
Zip	:	48182-9106
Country	:	US
Telephone Number	:	734-847-7640
Fax Number	:	734-847-7486

Provider Business Practice Location Address
First Line	:	6601 LEWIS AVE.
Second Line	:
City	:	TEMPERANCE
State	:	MI
Zip	:	48182-9106
Country	:	US
Telephone Number	:	734-847-7640
Fax Number	:	734-847-7486

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/02/2013

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Directions to “ DR. JOSEPH A. LASCALA DC” Practice Location

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