Individual
MRS. COURTNEY Y LEDBETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13245 KESSLER RD, CAIRO, IL 62914-3101
(618) 734-4400
(618) 734-2884
Mailing address
13245 KESSLER RD, CAIRO, IL 62914-3101
(618) 734-4400
(618) 734-2884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-001657
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001657
—
IL
Enumeration date
08/02/2005
Last updated
12/08/2009
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