Provider Demographics
NPI:1194848572
Name:LEONARD J NORK DC
Entity Type:Organization
Organization Name:LEONARD J NORK DC
Other - Org Name:NORK CHIROPRACTIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NORK
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:570-455-0144
Mailing Address - Street 1:930 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1627
Mailing Address - Country:US
Mailing Address - Phone:570-455-0144
Mailing Address - Fax:570-455-6920
Practice Address - Street 1:930 W 21ST ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-1627
Practice Address - Country:US
Practice Address - Phone:570-455-0144
Practice Address - Fax:570-455-6920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001662-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA611616OtherHIGHMARK BLUE SHIELD
PA543246OtherAETNA
PA611616OtherHIGHMARK BLUE SHIELD