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General NPI Number Information
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NPI Number | 1184141087
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Entity Type | Individual
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Provider Name | LESLIE HOLMES
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Gender | Female
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 08/23/2017
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Provider Practice Location Address
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Address Line | 2885 HARRIS HILL RD
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City | DUNNSVILLE
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State | VA
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Zip | 22454-2064
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Country | US
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Telephone | 540-419-9050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1164
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560-1164
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Country | US
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Telephone | 540-419-9050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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