Individual
MARK L LEGNOLA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1717 SWEDE RD, SUITE 106, BLUE BELL, PA 19422-3375
(484) 688-0664
(484) 688-0667
Mailing address
1717 SWEDE RD, SUITE 106, BLUE BELL, PA 19422-3375
(484) 688-0664
(484) 688-0667
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006991-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0395472000
KEYSTONE
PA
01
—
2457323
AETNA PIN
PA
Enumeration date
08/11/2005
Last updated
09/19/2017
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