Provider Demographics
NPI:1508175936
Name:LEDDING, DANIEL OWEN JR (EMT-B)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:OWEN
Last Name:LEDDING
Suffix:JR
Gender:M
Credentials:EMT-B
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Other - Middle Name:
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Mailing Address - Street 1:BLDG 301, ANDREWS AVENUE
Mailing Address - Street 2:LYSTER ARMY HEALTH CLINIC
Mailing Address - City:FORT RUCKER
Mailing Address - State:AL
Mailing Address - Zip Code:36362-5333
Mailing Address - Country:US
Mailing Address - Phone:334-255-0452
Mailing Address - Fax:334-255-0446
Practice Address - Street 1:BLDG 301, ANDREWS AVENUE
Practice Address - Street 2:LYSTER ARMY HEALTH CLINIC
Practice Address - City:FORT RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36362-5333
Practice Address - Country:US
Practice Address - Phone:334-255-0452
Practice Address - Fax:334-255-0446
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXB1314969146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic