=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518011105
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES LEONARD STRONG D.C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23 HEYBERT DR
-----------------------------------------------------
City | BLAIRSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15717-7890
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-459-8155
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23 HEYBERT DR
-----------------------------------------------------
City | BLAIRSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15717-7890
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-459-8155
-----------------------------------------------------
Fax | 724-459-8131
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC006330L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------