Individual
MRS. ANTOINETTE JOSEPHINE LEGGITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17441 TRAIL END ROAD, MAYER, AZ 86333
(928) 632-4857
Mailing address
17441 TRAIL END ROAD, MAYER, AZ 86333
(928) 632-4857
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AHCCCS
STATE OF AZ
AZ
Enumeration date
12/11/2006
Last updated
07/08/2007
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