Provider Demographics
NPI:1871580373
Name:NORK, LEONARD JOSEPH JR (DC)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:JOSEPH
Last Name:NORK
Suffix:JR
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 1:930 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1627
Mailing Address - Country:US
Mailing Address - Phone:570-455-0144
Mailing Address - Fax:570-455-6920
Practice Address - Street 1:930 W 21ST ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-1627
Practice Address - Country:US
Practice Address - Phone:570-455-0144
Practice Address - Fax:570-455-6920
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001662L111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000614887Medicaid
PA543232OtherAETNA
PA111008OtherHIGHMARK BLUE SHIELD
PA350006410OtherRAILROAD MEDICARE
PA1001796OtherASHN
PA806038OtherBLUE CROSS NEPA