Provider Demographics
NPI:1053153577
Name:CULVER, LESLIE
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:CULVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 STANLEY CT NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-1814
Mailing Address - Country:US
Mailing Address - Phone:234-322-2331
Mailing Address - Fax:
Practice Address - Street 1:1606 STANLEY CT NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-1814
Practice Address - Country:US
Practice Address - Phone:234-322-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care