Individual
REMCO LEIDELMEIJER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 WINDANCE DR, CARRIERE, MS 39426-7947
(606) 590-1821
Mailing address
54 WINDANCE DR, CARRIERE, MS 39426-7947
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
941723
LA
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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