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Individual

ERNEST RICHARD LEDESMA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
124 POST HOUSE TRL, POOLER, GA 31322-9624
(912) 450-1468
(912) 450-1470
Mailing address
340 EISENHOWER DR, BLDG 1400 SUITE A, SAVANNAH, GA 31406-1600
(912) 401-0443
(912) 401-0445

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT003700
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
65BBBNL
MEDICARE INDIVIDUAL #
GA
01
PT003700
STATE BOARD OF PT
GA
Enumeration date
11/29/2006
Last updated
10/05/2010
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