Provider Demographics
NPI:1659503639
Name:BENESH, LEEANN LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:LEEANN
Middle Name:LYNN
Last Name:BENESH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LEEANN
Other - Middle Name:LYNN
Other - Last Name:CULBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:901 FRONT ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1838
Mailing Address - Country:US
Mailing Address - Phone:303-604-2987
Mailing Address - Fax:303-604-2997
Practice Address - Street 1:901 FRONT ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1838
Practice Address - Country:US
Practice Address - Phone:303-604-2987
Practice Address - Fax:303-604-2997
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor