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General NPI Number Information
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NPI Number | 1932267457
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Entity Type | Organization
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Legal Business Name | LEER CHIROPRACTIC CENTER PSC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 212 S MAIN ST
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City | LAOTTO
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State | IN
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Zip | 46763-0218
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Country | US
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Telephone | 260-897-3001
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | LAOTTO
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State | IN
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Zip | 46763-0218
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Country | US
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Telephone | 260-897-3001
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD W LEER
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Credential | DC
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Telephone | 260-897-3001
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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 | 51000066A
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License Number State | IN
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