Provider Demographics
NPI:1790094779
Name:OSBORN, LESLIE K (DC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:K
Last Name:OSBORN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1225
Mailing Address - Country:US
Mailing Address - Phone:620-665-5100
Mailing Address - Fax:620-665-5104
Practice Address - Street 1:1529 E 30TH AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1225
Practice Address - Country:US
Practice Address - Phone:620-665-5100
Practice Address - Fax:620-665-5104
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor