Provider Demographics
NPI:1235377896
Name:LEONETTE, JAMES W (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:LEONETTE
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 1:130 PROFESSIONAL PL
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-4599
Mailing Address - Country:US
Mailing Address - Phone:304-933-9355
Mailing Address - Fax:304-278-3348
Practice Address - Street 1:130 PROFESSIONAL PL
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-4599
Practice Address - Country:US
Practice Address - Phone:304-933-9355
Practice Address - Fax:304-278-3348
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3967111N00000X
WV928111N00000X
VA0104556672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor