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Individual

MENTRAL LEDBETTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ALC

Contact information

Practice address
216 2ND ST SW, GORDO, AL 35466-2221
(334) 654-1871
(205) 293-5516
Mailing address
1607 POWE RD, DEMOPOLIS, AL 36732-3431
(334) 654-1871

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C3433A
AL

Other

Enumeration date
06/20/2021
Last updated
07/19/2021
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