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Individual

RUSSELL A LEBLANC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
489 W MAIN ST, LAKE LEELANAU, MI 49653-9740
(231) 256-7877
(231) 256-9529
Mailing address
5585 E HOHNKE RD, CEDAR, MI 49621-9607
(231) 256-2558

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006832
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2694706
MI
01
950D510120
BLUE CROSS AND BLUE SHIELD OF MICHIGAN
MI
Enumeration date
05/31/2005
Last updated
07/08/2008
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