Provider Demographics
NPI:1861893018
Name:OLECK, LEAH (DC)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:OLECK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:HETEBRUEG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2066 CENTRAL DR
Mailing Address - Street 2:UNIT D
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4244
Mailing Address - Country:US
Mailing Address - Phone:920-430-0280
Mailing Address - Fax:
Practice Address - Street 1:2066 CENTRAL DR
Practice Address - Street 2:UNIT D
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4244
Practice Address - Country:US
Practice Address - Phone:920-430-0280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5042-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor