Individual
LEASA C NOVOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
271 SHERIDAN FOREST RD APT 1200, GOLDSBORO, NC 27534-7155
(785) 213-4505
Mailing address
321 S 8TH ST, SALINA, KS 67401-3915
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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