Ernest Richard Ledesma JR. PT

NPI 1063589042 - Specialist - 174400000X

NPI Details
NPI 1063589042
Gender Male
Enumeration Date 11/29/2006
Last Updated 10/05/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
124 POST HOUSE TRL
POOLER GA, 31322-9624, US
Phone (912) 450-1468
Fax (912) 450-1470
Business Location
340 EISENHOWER DR
BLDG 1400 SUITE A
SAVANNAH GA, 31406-1600, US
Phone (912) 401-0443
Fax (912) 401-0445
Toxanomy
Taxonomy Code 174400000X
License State Georgia
License Number PT003700
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According to our database, Ernest Richard Ledesma JR. PT NPI is 1063589042, taxonomy code is 174400000X and license number is PT003700, license state is located at Georgia. Ernest Richard Ledesma JR. PT physically located at 124 Post House Trl, Pooler GA, 31322-9624. NPI Number Ernest Richard Ledesma JR. PT has the Individual type.

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1063589042 NPI number is provided on an as is basis without warranty of any kind. 1063589042 is maintained by the National Plan & Provider Enumeration System. The contents of Ernest Richard Ledesma JR. PT are for informational purposes only.