Provider Demographics
NPI:1346748886
Name:HILES, LESLIE NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:NICOLE
Last Name:HILES
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 1:650 CEDAR CREEK GRADE STE 207
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6454
Mailing Address - Country:US
Mailing Address - Phone:540-667-7388
Mailing Address - Fax:
Practice Address - Street 1:650 CEDAR CREEK GRADE STE 207
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6454
Practice Address - Country:US
Practice Address - Phone:540-667-7388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0104557467OtherVA LICENSE