Healthcare Provider Details

I. General information

NPI: 1093670267
Provider Name (Legal Business Name): IRVING LEON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12371 S 900 E STE 101
DRAPER UT
84020-9834
US

IV. Provider business mailing address

21306 DENIT ESTATES DR
BROOKEVILLE MD
20833-1838
US

V. Phone/Fax

Practice location:
  • Phone: 801-544-2355
  • Fax:
Mailing address:
  • Phone: 385-207-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number14261735-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: