Individual
RYAN LEISY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
30544 HIGHWAY 200 STE 330, PONDERAY, ID 83852-5005
(208) 265-1900
Mailing address
P.O. BOX 26, KOOTENAI, ID 83840-5055
(208) 265-1900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH34717
WA
111N00000X
Chiropractor
Primary
CHIA-1250
ID
Other
Enumeration date
01/30/2007
Last updated
03/29/2018
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