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Organization
LESLE LONG, MDVIP, LLC
Active
Organization
LESLE LONG, MDVIP, LLC
Active
Parent organization
LESLE LONG, MDVIP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LESLE LONG, MDVIP, LLC
Authorized official
DR. LESLE D. LONG MD (OWNER)
(864) 530-0300
Entity
Organization
Contact information
Practice address
89 SONIA DR, SUITE A, GREER, SC 29650-4540
(864) 530-0300
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Enumeration date
06/22/2012
Last updated
06/22/2012
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