Individual
LESLIE HARVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 E 70TH ST, SAVANNAH, GA 31405-4813
(912) 692-0606
Mailing address
PO BOX 162910, ATLANTA, GA 30321-2910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005212
GA
363AM0700X
Medical Physician Assistant
005212
GA
363AS0400X
Surgical Physician Assistant
005212
GA
Other
Enumeration date
12/03/2007
Last updated
04/03/2008
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