Individual
MRS. LESLIE L RICKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03406
KS
225100000X
Physical Therapist
2004024413
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2229370
CCN NETWORK
—
01
—
2239593
FIRST HEALTH
—
01
—
34387
PREFERRED HEALTH PROFESS
—
01
—
34387021
BLUE CROSS BLUE SHIELD KC
MO
Enumeration date
07/22/2005
Last updated
11/22/2019
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