Provider Demographics
NPI:1689611964
Name:LEATHERMAN, CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:LEATHERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 AMES ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-3099
Mailing Address - Country:US
Mailing Address - Phone:785-594-4894
Mailing Address - Fax:785-594-2597
Practice Address - Street 1:412 AMES ST
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-3099
Practice Address - Country:US
Practice Address - Phone:785-594-4894
Practice Address - Fax:785-594-2597
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104834111N00000X
MO2002020065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
20-4236321OtherFEIN - INDIVIDUAL
MO33086038OtherBCBS
26-0522906OtherFEIN - GROUP