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General NPI Number Information
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NPI Number | 1285763300
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Entity Type | Individual
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Provider Name | LEONARD BRUCE FOX D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 992 DANBURY RD
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City | GEORGETOWN
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State | CT
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Zip | 06829
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Country | US
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Telephone | 203-544-9291
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Fax | 203-544-9631
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Provider Business Mailing Address
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Address Line | 992 DANBURY RD P.O. BOX 506
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City | GEORGETOWN
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State | CT
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Zip | 06829
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Country | US
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Telephone | 203-544-9291
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Fax | 203-544-9631
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1347
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License Number State | CT
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