Individual
LESLIE ANN BOGRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1125 W 25TH AVE, COVINGTON, LA 70433-1209
(985) 892-4563
Mailing address
1125 W 25TH AVE, COVINGTON, LA 70433-1209
(985) 892-4563
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1340057
—
LA
Enumeration date
11/04/2006
Last updated
07/09/2007
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