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General NPI Number Information
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NPI Number | 1780754663
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Entity Type | Organization
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Legal Business Name | THERESA M LEDBETTER DPM PC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 01/15/2008
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Provider Practice Location Address
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Address Line | 704 W MARGARET ST
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City | PASCO
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State | WA
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Zip | 99301-4127
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Country | US
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Telephone | 509-545-5906
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Fax | 509-547-5999
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Provider Business Mailing Address
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Address Line | 704 W MARGARET
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City | PASCO
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State | WA
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Zip | 99301
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Country | US
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Telephone | 509-545-5906
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Fax | 509-547-5999
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THERESA MARIE LEDBETTER CHEN
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Credential | DPM
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Telephone | 509-545-5906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DP00140
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | WA
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