Provider Demographics
NPI:1669645321
Name:LEERKES, JENNIFER (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:LEERKES
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 1:2020 NEW GARDEN RD
Mailing Address - Street 2:STE B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2487
Mailing Address - Country:US
Mailing Address - Phone:336-339-6407
Mailing Address - Fax:
Practice Address - Street 1:2020 NEW GARDEN RD
Practice Address - Street 2:STE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2487
Practice Address - Country:US
Practice Address - Phone:336-288-2464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor