Provider Demographics
NPI:1467429357
Name:RICKETTS, LEIGH ANN (DC)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:RICKETTS
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 1:6725 PAPERMILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4923
Mailing Address - Country:US
Mailing Address - Phone:865-584-7246
Mailing Address - Fax:865-584-7375
Practice Address - Street 1:6725 PAPERMILL DRIVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4923
Practice Address - Country:US
Practice Address - Phone:865-584-7246
Practice Address - Fax:865-584-7375
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC1808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U93686Medicare UPIN
TN3972889Medicare ID - Type Unspecified