MEDICARE: DR. FELICIA LEIPOLD DC, ATC

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	2255A2300X	Athletic Trainer	AL5207	FL
2	111N00000X	Chiropractor	S04104	MD

General Provider Information

NPI Number	:	1972274629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELICIA LEIPOLD DC, ATC

Provider Business Mailing Address
First Line	:	9501 OLD ANNAPOLIS RD STE 301
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6337
Country	:	US
Telephone Number	:	443-605-4221
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 OLD ANNAPOLIS RD STE 301
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6337
Country	:	US
Telephone Number	:	443-605-4221
Fax Number	:

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

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	01/23/2024

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