Individual
MARK JEFFREY LEISTICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1910 N 12TH ST, SUITE F, GRAND JUNCTION, CO 81501-2912
(970) 241-1199
(970) 241-2047
Mailing address
1910 N 12TH ST, SUITE F, GRAND JUNCTION, CO 81501-2912
(970) 241-1199
(970) 241-2047
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5206
CO
Other
Enumeration date
10/30/2007
Last updated
07/08/2010
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