Provider Demographics
NPI:1346440807
Name:WARTA STRECKER, LEIGH KA RENN (DC)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:KA RENN
Last Name:WARTA STRECKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LEIGH
Other - Middle Name:KA RENN
Other - Last Name:WARTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1135 COLLEGE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-4779
Mailing Address - Country:US
Mailing Address - Phone:620-805-5333
Mailing Address - Fax:
Practice Address - Street 1:1135 COLLEGE DR
Practice Address - Street 2:SUITE C
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-4779
Practice Address - Country:US
Practice Address - Phone:620-805-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05427111N00000X
NE1294111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099650Medicare PIN