Individual
MRS. LEKESHIA TESHAMBIE ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COSMETOLOGY
Contact information
Practice address
1211 TARBORO ST SW, WILSON, NC 27893-3555
(252) 234-6086
Mailing address
1211 TARBORO ST SW, WILSON, NC 27893-3555
(252) 234-6086
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
C52058
NC
335E00000X
Prosthetic/Orthotic Supplier
Primary
C52058
NC
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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