Provider Demographics
NPI:1447233291
Name:DURST, LESLIE F (PT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:F
Last Name:DURST
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 S SANTA FE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4162
Mailing Address - Country:US
Mailing Address - Phone:785-825-1361
Mailing Address - Fax:785-823-7077
Practice Address - Street 1:521 S SANTA FE AVE
Practice Address - Street 2:STE A
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4162
Practice Address - Country:US
Practice Address - Phone:785-825-1361
Practice Address - Fax:785-823-7077
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100002790BMedicaid
650015619OtherRAILROAD MEDICARE
KS208016OtherHEALTH PARTNERS
KS3620OtherPREFERRED HEALTH SYSTEM
KS100002790BMedicaid
KS208016OtherHEALTH PARTNERS
S54737Medicare UPIN