Individual
LESLIE THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5455 S HINMAN RD, WESTPHALIA, MI 48894-9210
(989) 640-0914
Mailing address
5455 S HINMAN RD, WESTPHALIA, MI 48894-9210
(989) 640-0914
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011981
MI
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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