Individual
LEANDRA M TONWEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8810 BLAKENEY PROFESSIONAL DR, CHARLOTTE, NC 28277-6595
(704) 910-1402
Mailing address
8810 BLAKENEY PROFESSIONAL DR, CHARLOTTE, NC 28277-6595
(704) 910-1402
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
103600
NC
363AM0700X
Medical Physician Assistant
Primary
103600
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460PA
—
SC
05
—
8102021
—
NC
Enumeration date
07/04/2006
Last updated
03/10/2014
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