Individual
MRS. LEA PONTIVEROS LANDER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5444
(804) 675-5420
Mailing address
5229 UPP ST, RICHMOND, VA 23234-4762
(804) 675-5444
(804) 675-5420
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1037158
VA
Other
Enumeration date
05/26/2006
Last updated
07/08/2007
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