Provider Demographics
NPI:1205817756
Name:LEIGHOW, JAMIE E (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:E
Last Name:LEIGHOW
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 1:2796 LYCOMING MALL DR
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-6466
Mailing Address - Country:US
Mailing Address - Phone:570-546-5454
Mailing Address - Fax:570-546-5468
Practice Address - Street 1:2796 LYCOMING MALL DR
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-6466
Practice Address - Country:US
Practice Address - Phone:570-546-5454
Practice Address - Fax:570-546-5468
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005149L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALE737854OtherBLUE SHIELD
PAP00190186OtherRAILROAD MEDICARE
PA812720OtherFIRST PRIORITY HEALTH
PA3555219OtherAETNA
PALE737854OtherBLUE SHIELD
PA177363Medicare PIN