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General NPI Number Information
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NPI Number | 1538376017
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Entity Type | Individual
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Provider Name | LESLIE MICHELLE BOYD L.A.T
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1301 DOTSY AVE
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City | ODESSA
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State | TX
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Zip | 79763-3576
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Country | US
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Telephone | 432-337-6655
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Fax | 432-334-5209
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Provider Business Mailing Address
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Address Line | 403 DOUGLAS DR
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City | ODESSA
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State | TX
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Zip | 79762-6855
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Country | US
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Telephone | 214-228-7924
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 2244
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License Number State | TX
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