Provider Demographics
NPI:1659118396
Name:JOHN, LEAH MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:MARIE
Last Name:JOHN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 NATALIE LN
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-3230
Mailing Address - Country:US
Mailing Address - Phone:610-730-6170
Mailing Address - Fax:
Practice Address - Street 1:1009 NATALIE LN
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-3230
Practice Address - Country:US
Practice Address - Phone:610-730-6170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor