Healthcare Provider Details
I. General information
NPI: 1124055652
Provider Name (Legal Business Name): HELLE LEAP D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21740 DEVONSHIRE ST
CHATSWORTH CA
91311-2954
US
IV. Provider business mailing address
21740 DEVONSHIRE ST
CHATSWORTH CA
91311-2954
US
V. Phone/Fax
- Phone: 818-998-1527
- Fax:
- Phone: 818-998-1527
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 20666 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: