Individual
RANDALL R LEANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
212 W. MAIN ST, PALMYRA, WI 53156-0250
(262) 495-4428
(262) 495-4480
Mailing address
PO BOX 250, PALMYRA, WI 53156-0250
(262) 495-4428
(262) 495-4480
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2787 - 012
WI
Other
Enumeration date
11/13/2006
Last updated
11/01/2011
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