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General NPI Number Information
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NPI Number | 1497964761
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Entity Type | Individual
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Provider Name | NICOLA THOMAS BLEGGI D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 28455 SOUTHFIELD RD
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076
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Country | US
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Telephone | 248-559-6228
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Fax | 248-559-6228
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Provider Business Mailing Address
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Address Line | 39142 MEETING HOUSE LN
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City | LIVONIA
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State | MI
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Zip | 48154-1002
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Country | US
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Telephone | 734-953-0479
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Fax | 248-559-6228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | NB300307
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License Number State | MI
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