Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2312 | MA |
NPI | 1114097052 |
---|---|
Provider Name | Dr. Jeffrey Leverone |
First Address | Norton, MA 02766-2571 |
Second Address | Norton, MA 02766-2571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 22/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6077380001 | MEDICARE DME PTAN (01) | MA |