Provider Demographics
NPI:1750158200
Name:LEONE, BRENT
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:
Last Name:LEONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20025 THACKER DR
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713-2753
Mailing Address - Country:US
Mailing Address - Phone:240-446-6658
Mailing Address - Fax:
Practice Address - Street 1:110 THOMAS JOHNSON DR STE 334
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4400
Practice Address - Country:US
Practice Address - Phone:240-446-6658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor