Provider Demographics
NPI:1750051322
Name:HAYES, LEONARD HUN
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:HUN
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:LEONARD
Other - Middle Name:
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:439 IRON LANTERN DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2723
Mailing Address - Country:US
Mailing Address - Phone:469-777-1411
Mailing Address - Fax:
Practice Address - Street 1:15510 OLIVE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-0710
Practice Address - Country:US
Practice Address - Phone:469-777-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021035532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor