Provider Demographics
NPI:1619205705
Name:LEYVA, MARIA J (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:J
Last Name:LEYVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1568 INDIAN TRAIL LILBURN RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-2613
Mailing Address - Country:US
Mailing Address - Phone:770-696-2404
Mailing Address - Fax:770-696-2135
Practice Address - Street 1:1568 INDIAN TRAIL LILBURN RD
Practice Address - Street 2:SUITE 105
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2613
Practice Address - Country:US
Practice Address - Phone:770-696-2404
Practice Address - Fax:770-696-2135
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR005705111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor