=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699756106
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORAH LEVEEN DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2005
-----------------------------------------------------
Last Update Date | 06/18/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 677 W MAIN ST
-----------------------------------------------------
City | HYANNIS
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02601-3493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-790-0606
-----------------------------------------------------
Fax | 508-790-0808
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 563
-----------------------------------------------------
City | HYANNIS
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02601-0563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-790-0606
-----------------------------------------------------
Fax | 508-790-0808
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2713
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------