Individual
MRS. SUMMER DAWN LESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
907 E WALKER ST, FULTON, MS 38843-8954
(662) 862-6140
(662) 862-6143
Mailing address
PO BOX 69, FULTON, MS 38843-0069
(662) 862-6140
(662) 862-6143
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4101
MS
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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