Individual
LESLIE JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
12303 DEPAUL DR, BRIDGETON, MO 63044-2727
(314) 344-7545
(314) 344-7258
Mailing address
1695 12 MILE RD STE 200, BERKLEY, MI 48072-2100
(248) 808-6012
(248) 808-6056
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901400370
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2017
Last updated
07/22/2020
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