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General NPI Number Information
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NPI Number | 1053883793
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Entity Type | Individual
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Provider Name | LESLIE ANNE DAVIS D.C.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2018
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 1326 N MAIN ST
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City | MERIDIAN
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State | ID
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Zip | 83642-1703
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Country | US
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Telephone | 208-861-6327
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Fax |
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Provider Business Mailing Address
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Address Line | 7153 N SPURWING RIM PL
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City | MERIDIAN
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State | ID
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Zip | 83646-4003
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Country | US
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Telephone | 208-861-6327
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIA-1873
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License Number State | ID
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