Provider Demographics
NPI:1538470042
Name:LESLIE MORRIS DC, LLC
Entity Type:Organization
Organization Name:LESLIE MORRIS DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-929-7818
Mailing Address - Street 1:751 E 36TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4141
Mailing Address - Country:US
Mailing Address - Phone:907-929-7818
Mailing Address - Fax:907-929-7861
Practice Address - Street 1:751 E 36TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4141
Practice Address - Country:US
Practice Address - Phone:907-929-7818
Practice Address - Fax:907-929-7861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty