Individual
DR. DEREK ALAN LEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
204 WARD CIR, SUITE 300, BRENTWOOD, TN 37027-7551
(615) 636-5923
(615) 915-3187
Mailing address
204 WARD CIR, SUITE 300, BRENTWOOD, TN 37027-7551
(615) 636-5923
(615) 915-3187
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
2649
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2649
STATE LICENSE #
TN
Enumeration date
03/01/2010
Last updated
12/10/2015
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