Individual
MRS. LESLIE VICKNAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
(R) R.T.
Contact information
Practice address
215 CANE RD., FRANKLIN, LA 70538-0142
(337) 519-5536
Mailing address
PO BOX 142, CENTERVILLE, LA 70522-0142
(337) 519-5536
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
630434
LA
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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