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NPI Code Detail

MEDICARE: LESLIE UTT

MEDICARE: LESLIE UTT
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
13747P1801XPersonal Care Attendant
23747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1992441091
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE UTT
Provider Business Mailing Address
First Line : 1313 LOCUST AVE
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-0072
Country : US
Telephone Number : 304-366-4750
Fax Number :
Provider Business Practice Location Address
First Line : 1313 LOCUST AVE
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-0072
Country : US
Telephone Number : 304-366-4750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2022
Last Update Date : 05/11/2022

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Directions to “ LESLIE UTT ” Practice Location

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