Organization
LESLIE MOBILITY INC
Active
Other names
McConnell, I / Custom Mobility
Organization subpart
No
Provider details
NPI number
Authorized official
MILLARD F LESLIE (PRES)
(989) 652-6693
Entity
Organization
Contact information
Practice address
126 S MAIN ST, FRANKENMUTH, MI 48734-1612
(989) 652-6693
(989) 652-6587
Mailing address
126 S MAIN ST, FRANKENMUTH, MI 48734-1612
(989) 652-6693
(989) 652-6587
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0267230001
DMERC REGION B
MI
05
—
3135711
—
MI
01
—
540G30287
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
03/20/2007
Last updated
08/28/2008
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