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General NPI Number Information
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NPI Number | 1144366881
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Entity Type | Organization
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Legal Business Name | LEICHTER & PHELAN P.C.
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/15/2008
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Provider Practice Location Address
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Address Line | 1622 MISHAWAKA AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-1427
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Country | US
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Telephone | 574-288-1234
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Fax | 574-288-4821
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Provider Business Mailing Address
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Address Line | 1622 MISHAWAKA AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-1427
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Country | US
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Telephone | 574-288-1234
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Fax | 574-288-4821
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN S LEICHTER
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Credential | D.C.
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Telephone | 574-288-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 51000143A
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License Number State | IN
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