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NPI Code Detail

MEDICARE: MS. QUEENETTA LEFLORE JR.

MEDICARE:  MS. QUEENETTA  LEFLORE JR.
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
1225700000XMassage TherapistMT012960GA

General Provider Information

NPI Number : 1588271423
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. QUEENETTA LEFLORE JR.
Provider Business Mailing Address
First Line : 1475 SAND BAY DR SW APT 3007
Second Line :
City : ATLANTA
State : GA
Zip : 30331-8989
Country : US
Telephone Number : 571-235-9967
Fax Number :
Provider Business Practice Location Address
First Line : 1475 SAND BAY DR SW APT 3007
Second Line :
City : ATLANTA
State : GA
Zip : 30331-8989
Country : US
Telephone Number : 571-235-9967
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2020
Last Update Date : 09/24/2020

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Directions to “ MS. QUEENETTA LEFLORE JR. ” Practice Location

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