Provider Demographics
NPI:1902219785
Name:BEHRENDS, LESLIE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MARIE
Last Name:BEHRENDS
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 1:2548 250 RD
Mailing Address - Street 2:
Mailing Address - City:WEBBER
Mailing Address - State:KS
Mailing Address - Zip Code:66970-5012
Mailing Address - Country:US
Mailing Address - Phone:785-875-3010
Mailing Address - Fax:
Practice Address - Street 1:KANSAS HWY 14
Practice Address - Street 2:
Practice Address - City:WEBBER
Practice Address - State:KS
Practice Address - Zip Code:66970
Practice Address - Country:US
Practice Address - Phone:785-875-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05632111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor