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NPI Code Detail

MEDICARE: LESLIE SEWELL BOC

MEDICARE: LESLIE SEWELL BOC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1518988435
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE SEWELL BOC
Provider Business Mailing Address
First Line : 123 SAND MOUNTAIN DR NE
Second Line :
City : ALBERTVILLE
State : AL
Zip : 35950-1709
Country : US
Telephone Number : 256-891-4030
Fax Number :
Provider Business Practice Location Address
First Line : 123 SAND MOUNTAIN DR NE
Second Line :
City : ALBERTVILLE
State : AL
Zip : 35950-1709
Country : US
Telephone Number : 256-891-4030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 04/26/2010

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Directions to “ LESLIE SEWELL BOC” Practice Location

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