Provider Demographics
NPI:1467593798
Name:GEARHART, LESLIE A (DC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:GEARHART
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:PO BOX 438
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:PA
Mailing Address - Zip Code:18917-0438
Mailing Address - Country:US
Mailing Address - Phone:215-603-1014
Mailing Address - Fax:267-873-5787
Practice Address - Street 1:1000 E WALNUT ST STE 706
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-5463
Practice Address - Country:US
Practice Address - Phone:267-404-2001
Practice Address - Fax:267-873-5787
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009705111N00000X
NYX0011351111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor