Provider Demographics
NPI:1184218448
Name:KEEHNE, LESLIE A (DC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:KEEHNE
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:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:HALLSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75650-1111
Mailing Address - Country:US
Mailing Address - Phone:903-926-5698
Mailing Address - Fax:903-483-0068
Practice Address - Street 1:1705 JUDSON RD STE 103-B
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-2938
Practice Address - Country:US
Practice Address - Phone:903-926-5698
Practice Address - Fax:903-483-0068
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor