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Individual

DR. KIM M LEIS-KEELING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
2021 WESTERN AVE, ALBANY, NY 12203-5069
(518) 869-3415
Mailing address
2021 WESTERN AVE, STE 102, ALBANY, NY 12203-5029
(518) 982-0200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4498
MN
111NS0005X
Sports Physician Chiropractor
Primary
X012138-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
210K8LE
BCBS
FM
01
45-4547459
CHIROPRACTIC
NY
Enumeration date
03/31/2006
Last updated
10/21/2020
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