Provider Demographics
NPI:1073663621
Name:BUCHKOWSKI, LEAH JANE (DC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:JANE
Last Name:BUCHKOWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:JANE
Other - Last Name:BUCHKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3969 S COBB DR SE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6358
Mailing Address - Country:US
Mailing Address - Phone:678-214-4445
Mailing Address - Fax:
Practice Address - Street 1:3969 S COBB DR SE
Practice Address - Street 2:SUITE 205
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6358
Practice Address - Country:US
Practice Address - Phone:678-214-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor