Provider Demographics
NPI:1386060002
Name:HUBBARD, LEAH (DC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1538
Mailing Address - Country:US
Mailing Address - Phone:563-927-9400
Mailing Address - Fax:563-927-6224
Practice Address - Street 1:215 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1538
Practice Address - Country:US
Practice Address - Phone:563-927-9400
Practice Address - Fax:563-927-6224
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA072371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor