Healthcare Provider Details

I. General information

NPI: 1366489718
Provider Name (Legal Business Name): DAWN M. LEIBRANDT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S PLATTE CLAY WAY SUITE C
KEARNEY MO
64060-7592
US

IV. Provider business mailing address

PO BOX 547
KEARNEY MO
64060-0547
US

V. Phone/Fax

Practice location:
  • Phone: 816-628-5701
  • Fax: 816-902-4125
Mailing address:
  • Phone: 816-628-5701
  • Fax: 816-902-4125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCE 005740
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: