Healthcare Provider Details

I. General information

NPI: 1295991115
Provider Name (Legal Business Name): DR. JOSEPH A. LASCALA & ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 LEWIS AVE SUITE J
TEMPERANCE MI
48182-9106
US

IV. Provider business mailing address

7400 LEWIS AVE SUITE J
TEMPERANCE MI
48182-9106
US

V. Phone/Fax

Practice location:
  • Phone: 734-847-7640
  • Fax: 734-847-7486
Mailing address:
  • Phone: 734-847-7640
  • Fax: 734-847-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301007176
License Number StateMI

VIII. Authorized Official

Name: DR. JOSEPH AUGUSTIN LASCALA
Title or Position: PHYSICIAN
Credential: D.C.
Phone: 734-847-7640