Provider Demographics
NPI:1114001203
Name:HAYES, LESLIE MASK (DC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MASK
Last Name:HAYES
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 1:639 N COALTER ST
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-3404
Mailing Address - Country:US
Mailing Address - Phone:540-885-8877
Mailing Address - Fax:540-887-8493
Practice Address - Street 1:639 N COALTER ST
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-3404
Practice Address - Country:US
Practice Address - Phone:540-885-8877
Practice Address - Fax:540-887-8493
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA257530OtherSOUTHERN HEALTH
VA173244OtherANTHEM BLUE CROSS BLUE SH
VA9685035OtherCIGNA HEALTH CARE
VA9685035OtherCIGNA HEALTH CARE