Individual
MELLISSA AB HOLDEN LEBORGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(804) 828-9783
Mailing address
1300 N 12TH ST STE 301, PHOENIX, AZ 85006-2813
(602) 839-6968
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
005709
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2008
Last updated
10/19/2020
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