Individual
MARYN LEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.
Contact information
Practice address
1275 S WESTERN DR, CORNVILLE, AZ 86325-5201
(928) 649-1340
Mailing address
1275 S WESTERN DR, CORNVILLE, AZ 86325-5201
(928) 649-1340
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM0159
AZ
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
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