Provider Demographics
NPI:1629374855
Name:JACOBS, LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:
Last Name:JACOBS
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 1:40000 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:PAONIA
Mailing Address - State:CO
Mailing Address - Zip Code:81428-6100
Mailing Address - Country:US
Mailing Address - Phone:949-415-9373
Mailing Address - Fax:
Practice Address - Street 1:40000 CEDAR DR
Practice Address - Street 2:
Practice Address - City:PAONIA
Practice Address - State:CO
Practice Address - Zip Code:81428-6100
Practice Address - Country:US
Practice Address - Phone:949-415-9373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-05
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31852111N00000X
COCHR.0008441111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor