Individual
LESLIE N. RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
725 CAMPBELLSVILLE BYP, CAMPBELLSVILLE, KY 42718-8846
(270) 465-3669
(270) 789-0584
Mailing address
725 CAMPBELLSVILLE BYPASS, CAMPBELLSVILLE, KY 42718-1596
(270) 465-3669
(270) 789-0584
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
851-DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77008514
—
KY
Enumeration date
02/28/2007
Last updated
06/02/2010
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