Provider Demographics
NPI:1700350378
Name:LE, ANTHONY ORLANDO (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ORLANDO
Last Name:LE
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 1:1706 SE WALTON BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3201
Mailing Address - Country:US
Mailing Address - Phone:479-464-4413
Mailing Address - Fax:479-464-4430
Practice Address - Street 1:1706 SE WALTON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3201
Practice Address - Country:US
Practice Address - Phone:479-464-4413
Practice Address - Fax:479-464-4430
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor