Individual
MISS LESLIE TERESA BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1089 W GRANADA BLVD, SUITE 3, ORMOND BEACH, FL 32174-8116
(386) 679-0972
Mailing address
944 S PENINSULA DR, #202, DAYTONA BEACH, FL 32118-6403
(386) 679-0972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA22517
FL
Other
Enumeration date
12/04/2006
Last updated
07/21/2008
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