Provider Demographics
NPI:1205178423
Name:TEW, LEANNE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:MARIE
Last Name:TEW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 N MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-8386
Mailing Address - Country:US
Mailing Address - Phone:770-864-1195
Mailing Address - Fax:770-864-1169
Practice Address - Street 1:480 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8386
Practice Address - Country:US
Practice Address - Phone:770-864-1195
Practice Address - Fax:770-864-1169
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor