Provider Demographics
NPI:1366489718
Name:LEIBRANDT, DAWN M (DC)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:M
Last Name:LEIBRANDT
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:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-0547
Mailing Address - Country:US
Mailing Address - Phone:816-628-5701
Mailing Address - Fax:816-902-4125
Practice Address - Street 1:211 S PLATTE CLAY WAY
Practice Address - Street 2:SUITE C
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-7592
Practice Address - Country:US
Practice Address - Phone:816-628-5701
Practice Address - Fax:816-902-4125
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCE 005740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0001446Medicare ID - Type Unspecified
MOU30862Medicare UPIN