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MR. LESLIE RAY WALTMAN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
8717 W 110TH ST, SUITE 600, OVERLAND PARK, KS 66210-2144
(205) 474-3208
Mailing address
1308 E BRIGGS DR, MACON, MO 63552-1919
(660) 415-5215

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-115596
AL
163W00000X
Registered Nurse
2011040586
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2012006261
MO

Other

Enumeration date
12/08/2011
Last updated
02/19/2018
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