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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