Organization
LESA LANDON AND AMBER LANDON
Active
Organization
LESA LANDON AND AMBER LANDON
Active
Other names
Happy Feet
Organization subpart
No
Provider details
NPI number
Authorized official
LESA LANDON (GENERAL PARTNER)
(918) 801-5991
Entity
Organization
Contact information
Practice address
63153 EAST 290 ROAD, GROVE, OK 74344
(918) 801-5991
Mailing address
PO BOX 450164, GROVE, OK 74345-0164
(918) 944-3442
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OKB5889
MEDICARE PTAN
OK
Enumeration date
11/05/2009
Last updated
03/31/2010
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