Provider Information for 1114215621
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ANN F. LEGIERSKI
Sex: Female
NPI: 1114215621
Last Updated: 2024-06-20
Certification Date: 2024-06-20
Certification Date: 2024-06-20
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114215621 | ||||||||||||||||
| Enumeration Date | 2011-07-18 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 515 N PALM CANYON DR PALM SPRINGS, CA 92262-5543 United States Phone: | Fax: | ||||||||||||||||
| Primary Practice Address | 515 N PALM CANYON DR PALM SPRINGS, CA 92262-5543 United States Phone: 760-799-6878 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 55475 SANTA FE TRL | ||||||||||||||||
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