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General NPI Number Information
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NPI Number | 1932593365
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Entity Type | Individual
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Provider Name | JESSICA NOEL LEIGHTON DC, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 11/10/2024
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Provider Practice Location Address
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Address Line | 62607 EDGEWOOD CIR
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City | LAWTON
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State | MI
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Zip | 49065-8688
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Country | US
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Telephone | 630-995-3189
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Fax | 630-536-8454
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Provider Business Mailing Address
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Address Line | 62607 EDGEWOOD CIR
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City | LAWTON
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State | MI
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Zip | 49065-8688
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Country | US
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Telephone | 630-995-3189
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Fax | 630-536-8454
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-315530
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038-012747
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License Number State | IL
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