Provider Demographics
NPI:1770710592
Name:VILENSKY, LESLIE E (ND)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:E
Last Name:VILENSKY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 COLUMBUS AVE S
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-1938
Mailing Address - Country:US
Mailing Address - Phone:952-758-5988
Mailing Address - Fax:
Practice Address - Street 1:702 COLUMBUS AVE S
Practice Address - Street 2:
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-1938
Practice Address - Country:US
Practice Address - Phone:952-758-5988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA902175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath