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General NPI Number Information
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NPI Number | 1861662835
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Entity Type | Organization
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Legal Business Name | ELIZABETH LE
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 1942 WILLIAMS BLVD STE 4
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City | KENNER
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State | LA
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Zip | 70062-6285
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Country | US
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Telephone | 504-443-0680
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Fax |
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Provider Business Mailing Address
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Address Line | 1942 WILLIAMS BLVD STE 4
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City | KENNER
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State | LA
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Zip | 70062-6285
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Country | US
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Telephone | 504-443-0680
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | ELIZABETH LE
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Credential | DPM
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Telephone | 504-443-0680
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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 | PD173R
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License Number State | LA
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