Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 272750 | OR |
NPI | 1063494946 |
---|---|
Provider Name | Dr. John K Legat |
First Address | Springfield, OR 97477-6736 |
Second Address | Eugene, OR 97401-2142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U30036 | (02) | OR |