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General NPI Number Information
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NPI Number | 1336352434
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Entity Type | Individual
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Provider Name | TERESINA ENRICHETTA LEO RPH
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4343 MERLE HAY RD
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City | DES MOINES
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State | IA
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Zip | 50310-1411
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Country | US
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Telephone | 515-276-4845
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Fax | 515-331-3163
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Provider Business Mailing Address
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Address Line | 3728 SW 12TH ST
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City | DES MOINES
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State | IA
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Zip | 50315-3078
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Country | US
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Telephone | 515-243-4612
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18675
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License Number State | IA
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