Individual
LESLIE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MARKET ST STE 4103, BREVARD, NC 28712-5636
(828) 877-2110
Mailing address
4 MARKET ST STE 4103, BREVARD, NC 28712-5636
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4370
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A4370
LICENSE NUMBER
NC
Enumeration date
03/02/2015
Last updated
03/02/2015
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