Individual
LESLIE SUSAN CAVAZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3911 AVENUE B STE 2300, SCOTTSBLUFF, NE 69361-4617
(308) 630-1055
(308) 630-2060
Mailing address
3911 AVENUE B STE 2300, SCOTTSBLUFF, NE 69361-4617
(308) 630-1055
(308) 630-2060
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
31869
NE
Other
Enumeration date
05/30/2011
Last updated
09/09/2019
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