MEDICARE: NIKKI LECLAIR

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

General Provider Information

NPI Number	:	1548651086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIKKI LECLAIR

Provider Business Mailing Address
First Line	:	432 W M 55
Second Line	:
City	:	TAWAS CITY
State	:	MI
Zip	:	48763-9239
Country	:	US
Telephone Number	:	989-362-8991
Fax Number	:	989-362-6237

Provider Business Practice Location Address
First Line	:	432 W M 55
Second Line	:
City	:	TAWAS CITY
State	:	MI
Zip	:	48763-9239
Country	:	US
Telephone Number	:	989-362-8991
Fax Number	:	989-362-6237

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JANET ALVEY
Credential	:
Telephone Number	:	989-362-8991

Provider Enumeration Date	:	02/05/2015
Last Update Date	:	02/05/2015

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Directions to “NIKKI LECLAIR ” Practice Location

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