Individual
TAMMY JO LESLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4118 LINCOLN RD, STANDISH, MI 48658-9432
(989) 359-9472
Mailing address
4118 LINCOLN RD, STANDISH, MI 48658-9432
(989) 359-9472
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
171WH0202X
MI
171WH0202X
Home Modifications Contractor
Primary
L240785420610
MI
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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