Individual
MRS. LESLI MACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1204 FRANKLIN RD SW, ROANOKE, VA 24016-4606
(540) 981-1439
(540) 345-5446
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
(540) 224-5684
Taxonomy
Speciality
Code
Description
License number
State
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
0110003893
VA
363A00000X
Physician Assistant
0010-00865
NC
363A00000X
Physician Assistant
0110003893
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326244104
—
VA
Enumeration date
06/26/2007
Last updated
04/14/2026
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