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NPI Code Detail

MEDICARE: LESLI LANGSLET M.H.R.S.

MEDICARE: LESLI LANGSLET M.H.R.S.
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1336510171
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLI LANGSLET M.H.R.S.
Provider Business Mailing Address
First Line : PO BOX 2168
Second Line :
City : FORT BRAGG
State : CA
Zip : 95437-2168
Country : US
Telephone Number : 707-961-0172
Fax Number : 844-388-6167
Provider Business Practice Location Address
First Line : 101 N FRANKLIN ST
Second Line :
City : FORT BRAGG
State : CA
Zip : 95437-3602
Country : US
Telephone Number : 707-961-0172
Fax Number : 844-388-6167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2015
Last Update Date : 10/19/2015

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