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General NPI Number Information
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NPI Number | 1942577374
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Entity Type | Individual
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Provider Name | LEANNE MARIE WALTON D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 522 N SUGAR GROVE PKWY STE C
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City | SUGAR GROVE
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State | IL
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Zip | 60554
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Country | US
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Telephone | 309-696-8803
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Fax |
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Provider Business Mailing Address
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Address Line | 522 N SUGAR GROVE PKWY STE C
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City | SUGAR GROVE
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State | IL
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Zip | 60554-8111
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Country | US
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Telephone | 309-696-8803
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.012077
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License Number State | IL
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