Provider Demographics
NPI:1316109887
Name:LEASON, BROOKE (ND)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:LEASON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 AVE. JESUS T. PINERO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00921
Mailing Address - Country:UM
Mailing Address - Phone:787-793-9400
Mailing Address - Fax:
Practice Address - Street 1:1270 AVE. JESUS T. PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00921
Practice Address - Country:UM
Practice Address - Phone:787-793-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath