Provider Demographics
NPI:1689828386
Name:FUSION HEALTHWORKS, LLC
Entity Type:Organization
Organization Name:FUSION HEALTHWORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LEITZKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-449-1555
Mailing Address - Street 1:821 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1197
Mailing Address - Country:US
Mailing Address - Phone:302-449-1555
Mailing Address - Fax:302-449-2908
Practice Address - Street 1:821 N BROAD ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1197
Practice Address - Country:US
Practice Address - Phone:302-449-1555
Practice Address - Fax:302-449-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty