Provider Demographics
NPI:1528412855
Name:CHAMBERLIN, LEAH
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 OLD NECK RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9408
Mailing Address - Country:US
Mailing Address - Phone:207-232-1094
Mailing Address - Fax:
Practice Address - Street 1:210 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2424
Practice Address - Country:US
Practice Address - Phone:207-775-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-23
Last Update Date:2016-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist