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NPI Code Detail

MEDICARE: LESLIE HEATH

MEDICARE: LESLIE HEATH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1306381983
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE HEATH
Provider Business Mailing Address
First Line : 529 S PATTEN RD
Second Line :
City : PATTEN
State : ME
Zip : 04765-3007
Country : US
Telephone Number : 207-528-2285
Fax Number :
Provider Business Practice Location Address
First Line : 529 S PATTEN RD
Second Line :
City : PATTEN
State : ME
Zip : 04765-3007
Country : US
Telephone Number : 207-528-2285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2017
Last Update Date : 01/05/2017

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Directions to “ LESLIE HEATH ” Practice Location

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