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Individual

DR. LESLIE ANN CHURCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
27607 STATE ROAD 56, SUITE 101, WESLEY CHAPEL, FL 33544-8834
(813) 406-4993
(813) 406-4997
Mailing address
27607 STATE ROAD 56, SUITE 101, WESLEY CHAPEL, FL 33544-8834
(813) 406-4993
(813) 406-4997

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3438
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
620574700
FL
Enumeration date
08/24/2005
Last updated
11/05/2009
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