Provider Demographics
NPI:1841647336
Name:LE, ANDREW (DC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
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 1:403 W LINCOLN HWY
Mailing Address - Street 2:SUIT NUMBER 108
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2559
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:403 W LINCOLN HWY
Practice Address - Street 2:SUIT NUMBER 108
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2559
Practice Address - Country:US
Practice Address - Phone:610-524-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011152111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation