Provider Demographics
NPI:1679793848
Name:LEPPEK, ADRIANNA L (OD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANNA
Middle Name:L
Last Name:LEPPEK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-4121
Mailing Address - Country:US
Mailing Address - Phone:586-997-1249
Mailing Address - Fax:
Practice Address - Street 1:45460 MARKET ST
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-6224
Practice Address - Country:US
Practice Address - Phone:586-580-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003765152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist