Healthcare Provider Details

I. General information

NPI: 1376061341
Provider Name (Legal Business Name): CURTIS ANDREW LEGG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 06/12/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 IN-39 BYPASS
MARTINSVILLE IN
46151
US

IV. Provider business mailing address

1100 IN-39 BYPASS
MARTINSVILLE IN
46151
US

V. Phone/Fax

Practice location:
  • Phone: 765-315-0680
  • Fax:
Mailing address:
  • Phone: 765-315-0680
  • Fax: 765-315-0681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002993A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: