MEDICARE: DR. JAMES W LEONETTE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3967	OH
2	111N00000X	Chiropractor	928	WV
3	111N00000X	Chiropractor	0104556672	VA

General Provider Information

NPI Number	:	1235377896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES W LEONETTE D.C.

Provider Business Mailing Address
First Line	:	130 PROFESSIONAL PL
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-4599
Country	:	US
Telephone Number	:	304-933-9355
Fax Number	:	304-278-3348

Provider Business Practice Location Address
First Line	:	130 PROFESSIONAL PL
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-4599
Country	:	US
Telephone Number	:	304-933-9355
Fax Number	:	304-278-3348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2009
Last Update Date	:	04/11/2019

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