Healthcare Provider Details

I. General information

NPI: 1922063809
Provider Name (Legal Business Name): ROBERT JOHN LEINDECKER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E SAGINAW HWY
GRAND LEDGE MI
48837-9419
US

IV. Provider business mailing address

900 E SAGINAW HWY
GRAND LEDGE MI
48837-9419
US

V. Phone/Fax

Practice location:
  • Phone: 517-627-9111
  • Fax: 517-627-1023
Mailing address:
  • Phone: 517-627-9111
  • Fax: 517-627-1023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301006179
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: