Individual
JEFFREY LEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 ROE RD, GREENVILLE, SC 29611-7423
(864) 295-2308
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28792
SC
Other
Enumeration date
10/23/2024
Last updated
12/23/2024
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