Healthcare Provider Details

I. General information

NPI: 1073720587
Provider Name (Legal Business Name): LEONARD LEE HARTMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MASON STREET
GREENEVILLE TN
37745
US

IV. Provider business mailing address

155 MASON STREET
GREENEVILLE TN
37745
US

V. Phone/Fax

Practice location:
  • Phone: 423-638-5361
  • Fax: 423-638-2784
Mailing address:
  • Phone: 423-638-5361
  • Fax: 423-638-2784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number104
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: