Individual
LESLIE C. JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARRT, RPA
Contact information
Practice address
503 N MAPLE ST, STE 300, EFFINGHAM, IL 62401-2006
(217) 340-1340
Mailing address
15831 N 1400TH ST, EFFINGHAM, IL 62401-5210
(720) 427-3016
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04004826
—
CO
Enumeration date
02/27/2007
Last updated
05/06/2015
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