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Individual

TELLY LESHAN OWENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1405 WESTOVER HILLS BLVD STE 1A, RICHMOND, VA 23225-3153
(804) 424-3260
(804) 424-3261
Mailing address
4331 BATHGATE RD, RICHMOND, VA 23234-3581
(804) 549-9115

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
752156
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
81-4060372
VA
Enumeration date
07/14/2017
Last updated
09/22/2020
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