MEDICARE: DR. LESLIE SUZANNE SIZEMORE D.C.

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
1	111N00000X	Chiropractor	4362	NC
2	111N00000X	Chiropractor	3993	SC

General Provider Information

NPI Number	:	1710320403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE SUZANNE SIZEMORE D.C.

Provider Business Mailing Address
First Line	:	1267 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-322-2297
Fax Number	:

Provider Business Practice Location Address
First Line	:	1267 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2353
Country	:	US
Telephone Number	:	803-322-2297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2013
Last Update Date	:	09/08/2015

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