Provider Demographics
NPI:1861232894
Name:LEITSCHUH, BAILEY (DC)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:LEITSCHUH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 THOUVENOT LN STE 100
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7222
Mailing Address - Country:US
Mailing Address - Phone:618-234-8300
Mailing Address - Fax:
Practice Address - Street 1:409 MERAMEC BLVD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-3906
Practice Address - Country:US
Practice Address - Phone:636-429-2024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024018845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor