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General NPI Number Information
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NPI Number | 1699010397
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Entity Type | Organization
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Legal Business Name | DANIELLE LEDET, OD LLC
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 1654 GADSDEN HWY
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3104
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Country | US
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Telephone | 205-655-9452
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Fax |
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Provider Business Mailing Address
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Address Line | 1654 GADSDEN HIGHWAY
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City | TRUSSVILLE
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State | AL
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Zip | 35235
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DANIELLE LEDET
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Credential |
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Telephone | 205-655-9452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-C85-TA-939
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License Number State | AL
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