Healthcare Provider Details

I. General information

NPI: 1942264874
Provider Name (Legal Business Name): LEAH M CHARNEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH M KUK D.C.

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3076 EAGLE VALLEY RD.
MILL HALL PA
17751-1626
US

IV. Provider business mailing address

3076 EAGLE VALLEY RD.
MILL HALL PA
17751-1626
US

V. Phone/Fax

Practice location:
  • Phone: 570-726-2000
  • Fax: 570-726-8012
Mailing address:
  • Phone: 570-726-2000
  • Fax: 570-726-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009328
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberAJ009137
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: