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1003312067
JACOB LEEDEKERKEN
CHARLOTTE, NC
NPI
1003312067
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: NC 238485)
Enumeration Date
2018-03-30
Last Update Date
2018-04-03
Business Address
JACOB LEEDEKERKEN
1000 BLYTHE BLVD
CHARLOTTE, NC 28203-5812
Phone number: 704-355-3181
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Mailing Address
JACOB LEEDEKERKEN
813 12TH ST NE
WASHINGTON, DC 20002-4435
Phone number: 770-598-9580
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