Provider Demographics
NPI:1073229035
Name:LEEK, SHELIA (PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:LEEK
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 MILAM DR
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-2977
Mailing Address - Country:US
Mailing Address - Phone:469-630-1803
Mailing Address - Fax:
Practice Address - Street 1:133 MILAM DR
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-2977
Practice Address - Country:US
Practice Address - Phone:469-630-1803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy