Provider Demographics
NPI:1417620246
Name:LEONARD, PAIGE (DC)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:
Last Name:LEONARD
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 1:325 SOUND RD STE 205
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-7813
Mailing Address - Country:US
Mailing Address - Phone:910-803-1844
Mailing Address - Fax:
Practice Address - Street 1:325 SOUND RD STE 205
Practice Address - Street 2:
Practice Address - City:HOLLY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:28445-7813
Practice Address - Country:US
Practice Address - Phone:910-803-1844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor