Provider Demographics
NPI:1376584383
Name:SMITH, LEANNE C (DC)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:C
Last Name:SMITH
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 8
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:18622-0008
Mailing Address - Country:US
Mailing Address - Phone:570-951-6534
Mailing Address - Fax:
Practice Address - Street 1:184 WATERTON ROAD
Practice Address - Street 2:
Practice Address - City:SHICKSHINNY
Practice Address - State:PA
Practice Address - Zip Code:18655
Practice Address - Country:US
Practice Address - Phone:570-951-6534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor