Provider Demographics
NPI:1407881444
Name:LEAVITT, CATHERINE C (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:C
Last Name:LEAVITT
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 1:1451 BELLE HAVEN RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-1201
Mailing Address - Country:US
Mailing Address - Phone:703-660-6770
Mailing Address - Fax:703-660-6294
Practice Address - Street 1:1451 BELLE HAVEN RD
Practice Address - Street 2:SUITE 330
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-1201
Practice Address - Country:US
Practice Address - Phone:703-660-6770
Practice Address - Fax:703-660-6294
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VALE702186Medicare ID - Type Unspecified