Leist, Ltd.

NPI #1710239264 in Olney, Illinois

Provider Information

NPI Number
1710239264
Entity Type
Organization
Organization Name
Leist, Ltd.
Primary Specialty
Clinic/Center
Enumeration Date
Oct 9, 2012
Last Updated
Oct 9, 2012

Practice Location

Address
104 N GRANT ST
City
Olney
ZIP Code
62450-2612
Phone
(618) 395-7246

Authorized Official

Name
DR. DEREK ALAN LEIST, D.C.
Title
PRESIDENT
Phone
(314) 954-1885

Specialties & Taxonomy Codes

Specialty
Clinic/Center

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