MEDICARE: DR. LESLIE MICHELLE BRYAN D.C.

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	2238	AL

General Provider Information

NPI Number	:	1548430598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE MICHELLE BRYAN D.C.

Provider Business Mailing Address
First Line	:	11322 US HIGHWAY 31
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36527-5897
Country	:	US
Telephone Number	:	251-626-8242
Fax Number	:	251-626-2622

Provider Business Practice Location Address
First Line	:	11322 US HIGHWAY 31
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36527-5897
Country	:	US
Telephone Number	:	251-626-8242
Fax Number	:	251-626-2622

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

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	06/06/2024

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