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1104839208
LESLIE MARK LANG
PROVO, UT
NPI
1104839208
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: UT 2613601205)
Enumeration Date
2006-08-14
Last Update Date
2007-07-08
Business Address
-- LESLIE MARK LANG MD
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-7707
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Mailing Address
-- LESLIE MARK LANG MD
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-357-7707
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