Individual
MELISSA CHRISTINE LEBOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
14418 W MEEKER BLVD, SUITE 110, SUN CITY WEST, AZ 85375-5283
(623) 584-9500
(623) 584-4945
Mailing address
6771 W MINER TRL, PEORIA, AZ 85383-3008
(623) 748-8373
(623) 748-8373
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4327
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4327
LICENSE
AZ
Enumeration date
10/10/2008
Last updated
07/27/2011
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