Provider Demographics
NPI:1053670018
Name:D. G. & LEEDS, LLC
Entity Type:Organization
Organization Name:D. G. & LEEDS, LLC
Other - Org Name:ORLANDO PAIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUNAID
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:CH8476
Authorized Official - Phone:407-478-6777
Mailing Address - Street 1:280 S STATE ROAD 434
Mailing Address - Street 2:1049A
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3816
Mailing Address - Country:US
Mailing Address - Phone:407-478-6777
Mailing Address - Fax:
Practice Address - Street 1:280 S STATE ROAD 434
Practice Address - Street 2:1049A
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3816
Practice Address - Country:US
Practice Address - Phone:407-478-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty