Individual
DR. LEONARD J. ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
8151 RIDGE AVE, PHILADELPHIA, PA 19128-2902
(215) 487-2500
(215) 487-7463
Mailing address
8151 RIDGE AVE, PHILADELPHIA, PA 19128-2902
(215) 487-2500
(215) 487-7463
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
DC008037L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0856152000
IBC/KEYSTONE- PROVIDER#
PA
01
—
2671626
AETNA PROVIDER#
PA
01
—
906443
HIGHMARK BS PROVIDER#
PA
Enumeration date
04/10/2006
Last updated
06/25/2010
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