Provider Demographics
NPI:1467569269
Name:GIDEON, LEIGH S (DC)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:S
Last Name:GIDEON
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 1:2472 BRIENSBURG TATUMSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-7264
Mailing Address - Country:US
Mailing Address - Phone:270-564-0732
Mailing Address - Fax:
Practice Address - Street 1:2472 BRIENSBURG TATUMSVILLE RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-7264
Practice Address - Country:US
Practice Address - Phone:270-564-0732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4995111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor