Individual
MS. LESLIE DAWN VASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 PEMBROKE FAIRVIEW RD, PEMBROKE, KY 42266-9452
(270) 475-9388
(270) 475-9388
Mailing address
1225 PEMBROKE FAIRVIEW RD, PEMBROKE, KY 42266-9452
(270) 475-9388
(270) 475-9388
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
200205652
KY
Other
Enumeration date
07/20/2009
Last updated
07/20/2009
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