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General NPI Number Information
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NPI Number | 1689828386
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Entity Type | Organization
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Legal Business Name | FUSION HEALTHWORKS, LLC
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 821 N BROAD ST
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City | MIDDLETOWN
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State | DE
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Zip | 19709-1197
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Country | US
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Telephone | 302-449-1555
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Fax | 302-449-2908
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Provider Business Mailing Address
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Address Line | 821 N BROAD ST
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City | MIDDLETOWN
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State | DE
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Zip | 19709-1197
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Country | US
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Telephone | 302-449-1555
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Fax | 302-449-2908
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW LEITZKE
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Credential | DC
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Telephone | 302-449-1555
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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 | F10000484
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License Number State | DE
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