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Individual

LEON MAULTSBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1610 EMERALD LAKE CV APT 102, CASSELBERRY, FL 32707-6914
(323) 440-5313
Mailing address
801 DOUGLAS AVE, ALTAMONTE SPRINGS, FL 32714-5206
(407) 830-6412

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/29/2014
Last updated
09/29/2014
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