Healthcare Provider Details

I. General information

NPI: 1821092594
Provider Name (Legal Business Name): DAVID P LEONE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 W MAIN ST STE C
KENT OH
44240-2400
US

IV. Provider business mailing address

307 W MAIN ST STE C
KENT OH
44240-2400
US

V. Phone/Fax

Practice location:
  • Phone: 330-677-3628
  • Fax: 330-677-3626
Mailing address:
  • Phone: 330-677-3628
  • Fax: 330-677-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1574
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1574
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: