Provider Demographics
NPI:1386681575
Name:LEINBACH, STUART W (DC, CCEP)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:W
Last Name:LEINBACH
Suffix:
Gender:M
Credentials:DC, CCEP
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 8898
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52408-8898
Mailing Address - Country:US
Mailing Address - Phone:319-390-3914
Mailing Address - Fax:319-390-3928
Practice Address - Street 1:3726 QUEEN CT. SW
Practice Address - Street 2:SUITE 102
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404
Practice Address - Country:US
Practice Address - Phone:319-390-3914
Practice Address - Fax:319-390-3928
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA46108OtherBC/BS
IA1194282Medicaid
IA1194282Medicaid