Provider Demographics
NPI:1790467215
Name:LEONARD G RUTHERFORD DC LLC
Entity Type:Organization
Organization Name:LEONARD G RUTHERFORD DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-954-2176
Mailing Address - Street 1:141 E 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4006
Mailing Address - Country:US
Mailing Address - Phone:541-954-2176
Mailing Address - Fax:
Practice Address - Street 1:141 E 15TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4006
Practice Address - Country:US
Practice Address - Phone:541-954-2176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty