Individual
LAZORA LYNETTE LEAVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 SHALL CT, JACKSONVILLE, AR 72076-2422
(501) 680-7499
Mailing address
900 SHALL CT, JACKSONVILLE, AR 72076-2422
(501) 680-7499
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2125
AR
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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