Healthcare Provider Details

I. General information

NPI: 1710807268
Provider Name (Legal Business Name): LEGACY PARTNERS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45637 HAYES RD
SHELBY TWP MI
48315-6214
US

IV. Provider business mailing address

45637 HAYES RD
SHELBY TWP MI
48315-6214
US

V. Phone/Fax

Practice location:
  • Phone: 586-991-6471
  • Fax:
Mailing address:
  • Phone: 586-991-6471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: CHADWICK T JACKSON
Title or Position: OWNER
Credential: DC
Phone: 502-642-7079