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General NPI Number Information
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NPI Number | 1932560091
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Entity Type | Organization
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Legal Business Name | LEAH HUMPHRIES
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 115 TEMPLE ST
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City | OWEGO
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State | NY
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Zip | 13827-1420
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Country | US
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Telephone | 607-687-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 115 TEMPLE ST
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City | OWEGO
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State | NY
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Zip | 13827-1420
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. LEAH V HUMPHRIES
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Credential | DC
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Telephone | 337-296-6019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 70 012709
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License Number State | NY
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