Provider Demographics
NPI:1639459852
Name:SIERRA, LEIGH ALICIA TRECO (DC)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:ALICIA TRECO
Last Name:SIERRA
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 1:11343 SPRING GATE TRL
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-2547
Mailing Address - Country:US
Mailing Address - Phone:941-244-9028
Mailing Address - Fax:
Practice Address - Street 1:571 US HIGHWAY 41 BYP N
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-6044
Practice Address - Country:US
Practice Address - Phone:941-244-9028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFK404AMedicare Oscar/Certification