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General NPI Number Information
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NPI Number | 1619653169
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Entity Type | Individual
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Provider Name | SHAWN SHANNON LEONHARD D.O.M. , L.AC.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 265 MILL ST STE 500
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6179
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Country | US
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Telephone | 301-712-3342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 102
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City | MERCERSBURG
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State | PA
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Zip | 17236-0102
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Country | US
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Telephone | 904-710-1887
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U02982
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License Number State | MD
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