Provider Demographics
NPI:1518498187
Name:LEUPPIE, JOSHUA G (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:G
Last Name:LEUPPIE
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 1:1567 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1264
Mailing Address - Country:US
Mailing Address - Phone:716-877-0676
Mailing Address - Fax:
Practice Address - Street 1:1567 MILITARY RD
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1264
Practice Address - Country:US
Practice Address - Phone:716-877-0676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013079111N00000X
AZ8624111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor