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Individual

BRENT DAVID LEININGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
200 MAIN ST, WANAMINGO, MN 55983-3848
(507) 824-2336
Mailing address
PO BOX 214, WANAMINGO, MN 55983-0214
(507) 824-2336

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4210-012
WI
111N00000X
Chiropractor
Primary
4846
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
428319800
MN
Enumeration date
05/15/2006
Last updated
06/03/2009
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