Provider Demographics
NPI:1407818057
Name:OAKCHUNAS, LEO ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:ANTHONY
Last Name:OAKCHUNAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6311
Mailing Address - Country:US
Mailing Address - Phone:610-849-0779
Mailing Address - Fax:610-849-0824
Practice Address - Street 1:310 E BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6311
Practice Address - Country:US
Practice Address - Phone:610-849-0779
Practice Address - Fax:610-849-0824
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007894L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000067316Medicare ID - Type Unspecified
PAU93974Medicare UPIN