Provider Demographics
NPI:1306181433
Name:LAEMMLI, LESLIE E (IIS)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:E
Last Name:LAEMMLI
Suffix:
Gender:F
Credentials:IIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15635 BEVERLY ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3482
Mailing Address - Country:US
Mailing Address - Phone:913-897-4352
Mailing Address - Fax:
Practice Address - Street 1:15635 BEVERLY ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-3482
Practice Address - Country:US
Practice Address - Phone:913-897-4352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor