Provider Demographics
NPI:1528781861
Name:BURLEIGH, JON (DC)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:
Last Name:BURLEIGH
Suffix:
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 1:131 CAPSTONE CT
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-4277
Mailing Address - Country:US
Mailing Address - Phone:760-895-0657
Mailing Address - Fax:
Practice Address - Street 1:575 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3600
Practice Address - Country:US
Practice Address - Phone:707-255-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor