Individual
KENNETH ROBERT LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 534-3745
(814) 534-5677
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 534-3745
(814) 534-5677
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OT019054
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2018
Last updated
06/10/2019
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