Provider Demographics
NPI:1891288304
Name:LEEDER CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:LEEDER CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-434-4615
Mailing Address - Street 1:2725 JEFFERSON ST STE 4B
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1707
Mailing Address - Country:US
Mailing Address - Phone:760-434-4615
Mailing Address - Fax:760-434-7191
Practice Address - Street 1:2725 JEFFERSON ST STE 4B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1707
Practice Address - Country:US
Practice Address - Phone:760-434-4615
Practice Address - Fax:760-434-7191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16463111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty