=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821092594
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID P LEONE DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2005
-----------------------------------------------------
Last Update Date | 01/09/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 307 W MAIN ST STE C
-----------------------------------------------------
City | KENT
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44240-2400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-677-3628
-----------------------------------------------------
Fax | 330-677-3626
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 307 W MAIN ST STE C
-----------------------------------------------------
City | KENT
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44240-2400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-677-3628
-----------------------------------------------------
Fax | 330-677-3626
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 1574
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111NX0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Chiropractor
-----------------------------------------------------
License Number | 1574
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------