Organization
LESLIE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORTER BASS LESLIE M.D. (OWNER)
(580) 922-4283
Entity
Organization
Contact information
Practice address
NE HIGHWAY 60, SEILING, OK 73663-0838
(580) 922-4283
(580) 922-7717
Mailing address
PO BOX 838, SEILING, OK 73663-0838
(580) 922-4283
(580) 922-7717
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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