Provider Demographics
NPI:1285673020
Name:MOLCZAN, LEONARD JULIAN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:JULIAN
Last Name:MOLCZAN
Suffix:JR
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 1:33 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-2814
Mailing Address - Country:US
Mailing Address - Phone:215-928-9171
Mailing Address - Fax:215-928-9172
Practice Address - Street 1:33 S 3RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-2814
Practice Address - Country:US
Practice Address - Phone:215-928-9171
Practice Address - Fax:215-928-9172
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007614-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor