Organization
KNOW YOU'RE COVERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERIE LARRMARR LESEUR (OWNER)
(888) 685-7709
Entity
Organization
Contact information
Practice address
1217 CLOVER HILL LN, DESOTO, TX 75115-1509
(651) 285-6245
Mailing address
1217 CLOVER HILL LN, DESOTO, TX 75115-1509
(651) 285-6245
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
801529643
TX
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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