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Individual

DR. LESLIE M ELMS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
2150 3RD ST, BAKER CITY, OR 97814-2609
(541) 523-5858
(541) 523-7652
Mailing address
1105 E ST, BAKER CITY, OR 97814-1908
(541) 523-1649

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2569AT
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
082263
OR
Enumeration date
08/30/2005
Last updated
03/07/2023
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