Provider Demographics
NPI:1073720587
Name:HARTMAN, LEONARD LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:LEE
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MASON STREET
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745
Mailing Address - Country:US
Mailing Address - Phone:423-638-5361
Mailing Address - Fax:423-638-2784
Practice Address - Street 1:155 MASON STREET
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745
Practice Address - Country:US
Practice Address - Phone:423-638-5361
Practice Address - Fax:423-638-2784
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4157073OtherBCBS
TN3670746Medicaid
TN4157073OtherBCBS
TN3670746Medicaid