Provider Demographics
NPI:1467635631
Name:LECKER, JOSHUA ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALAN
Last Name:LECKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 TRENTON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-1633
Mailing Address - Country:US
Mailing Address - Phone:931-647-7644
Mailing Address - Fax:931-647-0122
Practice Address - Street 1:2106 TRENTON RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-1633
Practice Address - Country:US
Practice Address - Phone:931-647-7644
Practice Address - Fax:931-647-0122
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009694111N00000X
TN2506111N00000X
KY5369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor