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NPI Code Detail

MEDICARE: VICTOR LEACH DC

MEDICARE:   VICTOR  LEACH  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorB01213NV

General Provider Information

NPI Number : 1295880847
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR LEACH DC
Provider Business Mailing Address
First Line : 2520 SAINT ROSE PKWY
Second Line : STE 101
City : HENDERSON
State : NV
Zip : 89074-7783
Country : US
Telephone Number : 702-579-9876
Fax Number : 702-579-9877
Provider Business Practice Location Address
First Line : 2520 SAINT ROSE PKWY
Second Line : STE 101
City : HENDERSON
State : NV
Zip : 89074-7783
Country : US
Telephone Number : 702-579-9876
Fax Number : 702-579-9877
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 06/03/2009

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Directions to “ VICTOR LEACH DC” Practice Location

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