Individual
DEMETRE LEDLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2660 DEER ISLE CV, LAWRENCEVILLE, GA 30044-5263
(404) 956-0878
Mailing address
2660 DEER ISLE CV, LAWRENCEVILLE, GA 30044-5263
(404) 956-0878
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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