Organization
LEAVENGOOD CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY LINDELIE LEAVENGOOD DC (CEO)
(478) 988-4663
Entity
Organization
Contact information
Practice address
1238 S HOUSTON LAKE RD, STE 3, WARNER ROBINS, GA 31088-0723
(478) 988-4663
(478) 988-4881
Mailing address
1238 S HOUSTON LAKE RD, STE 3, WARNER ROBINS, GA 31088-0723
(478) 988-4663
(478) 988-4881
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2823
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00490421A
—
GA
01
—
1346304078
INDIVIUAL NPI
GA
Enumeration date
09/12/2007
Last updated
09/12/2007
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