Individual
LESLEY D LOOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
309 W BUTLER RD, MAULDIN, SC 29662-2531
(864) 297-1575
(864) 297-6256
Mailing address
11 ARDEN ST, GREENVILLE, SC 29607-1704
(864) 784-3442
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
TL1702
SC
Other
Enumeration date
11/02/2011
Last updated
11/15/2011
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