Provider Demographics
NPI:1851449482
Name:LEONARD, ROBERT ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ARTHUR
Last Name:LEONARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21800 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3331
Mailing Address - Country:US
Mailing Address - Phone:440-895-3500
Mailing Address - Fax:440-895-3501
Practice Address - Street 1:29540 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5115
Practice Address - Country:US
Practice Address - Phone:440-895-3500
Practice Address - Fax:440-895-3501
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH20-1566196OtherTAX IDENTIFICATION NUMBER