| Leo R Boisvert, DC | |
|
101 Malabu Dr, Suite #10, Lexington, KY 40503-3141 | |
| (859) 277-7521 | |
| (859) 275-2020 |
| Full Name | Leo R Boisvert |
|---|---|
| Gender | Male |
| Speciality | Chiropractor - Pediatric Chiropractor |
| Location | 101 Malabu Dr, Lexington, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912924655 | NPI | - | NPPES |
| 0017382990001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NP0017X | Chiropractor - Pediatric Chiropractor | 5052 (Kentucky) | Primary |
| Provider Name | Boisvert Enterprises Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1962753665 PECOS PAC ID: 8224400684 Enrollment ID: O20230211000413 |
| Mailing Address | Practice Location Address |
|---|---|
| Leo R Boisvert, DC 101 Malabu Dr, Suite #10, Lexington, KY 40503-3141 Ph: (859) 277-7521 | Leo R Boisvert, DC 101 Malabu Dr, Suite #10, Lexington, KY 40503-3141 Ph: (859) 277-7521 |
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