MEDICARE: DR. LESLIE NICOLE HILES DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104557467	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0104557467	OTHER	VA	VA LICENSE

General Provider Information

NPI Number	:	1346748886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE NICOLE HILES DC

Provider Business Mailing Address
First Line	:	650 CEDAR CREEK GRADE STE 207
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6454
Country	:	US
Telephone Number	:	540-667-7388
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 CEDAR CREEK GRADE STE 207
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6454
Country	:	US
Telephone Number	:	540-667-7388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2018
Last Update Date	:	01/30/2018

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