Individual
MARY SUSAN LEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 TRUXTON AVE, FORT WALTON BEACH, FL 32547-2460
(850) 862-4313
Mailing address
107 CRISTINE CT, NICEVILLE, FL 32578-4713
(850) 496-0951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 50906
FL
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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