MEDICARE: DR. LEIGH ANN ELCESER D.C.

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	LE007043	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0F3542	OTHER	MI	BLUE CARE NETWORK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	100649	OTHER	MI	GREAT LAKES HEALTH PLAN

General Provider Information

NPI Number	:	1952383549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEIGH ANN ELCESER D.C.

Provider Business Mailing Address
First Line	:	1044 JOSLYN AVE
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48340-2930
Country	:	US
Telephone Number	:	248-332-0111
Fax Number	:	248-332-0880

Provider Business Practice Location Address
First Line	:	1044 JOSLYN AVE
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48340-2930
Country	:	US
Telephone Number	:	248-332-0111
Fax Number	:	248-332-0880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	07/08/2007

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