Provider Demographics
NPI:1770649840
Name:BENHAM, LESLIE ANN (DC, DIPL AC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ANN
Last Name:BENHAM
Suffix:
Gender:F
Credentials:DC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 CORONA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3401
Mailing Address - Country:US
Mailing Address - Phone:720-333-1966
Mailing Address - Fax:303-698-2890
Practice Address - Street 1:515 CORONA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3401
Practice Address - Country:US
Practice Address - Phone:720-333-1966
Practice Address - Fax:303-698-2890
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor