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Individual
DR. WARNER DE LEEUW IV
Active
Individual
DR. WARNER DE LEEUW IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009355
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P57110001
MEDICARE PTAN
—
Enumeration date
01/10/2008
Last updated
04/04/2023
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