Provider Demographics
NPI:1427169341
Name:LEEDER, LEAH DANZIG (DC)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:DANZIG
Last Name:LEEDER
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 1:59 CHANNING RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1139
Mailing Address - Country:US
Mailing Address - Phone:617-964-5721
Mailing Address - Fax:
Practice Address - Street 1:1216 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-4638
Practice Address - Country:US
Practice Address - Phone:617-739-0217
Practice Address - Fax:617-738-9441
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor