Provider Demographics
NPI:1255436630
Name:BAERTLEIN-LEBERFING, KRISTA M (DC)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:M
Last Name:BAERTLEIN-LEBERFING
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 1:1228 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1929
Mailing Address - Country:US
Mailing Address - Phone:262-880-2063
Mailing Address - Fax:
Practice Address - Street 1:5332 SPRING ST
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-2910
Practice Address - Country:US
Practice Address - Phone:262-886-1213
Practice Address - Fax:262-886-4114
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3743-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor