Provider Demographics
NPI:1386636421
Name:LEONARD, ANNA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIE
Last Name:LEONARD
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 1:604 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:IA
Mailing Address - Zip Code:50841-1514
Mailing Address - Country:US
Mailing Address - Phone:641-322-4895
Mailing Address - Fax:641-322-4099
Practice Address - Street 1:604 7TH ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:IA
Practice Address - Zip Code:50841-1514
Practice Address - Country:US
Practice Address - Phone:641-322-4895
Practice Address - Fax:641-322-4099
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI5180Medicare ID - Type Unspecified