| Dr Kevin T Le, DC | |
|
4935 Jimmy Carter Blvd Ste 360, Norcross, GA 30093-3536 | |
| (470) 545-0275 | |
| (470) 246-5961 |
| Full Name | Dr Kevin T Le |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 4935 Jimmy Carter Blvd Ste 360, Norcross, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851485775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIR009736 (Georgia) | Primary |
| 208D00000X | General Practice | CHIR009736 (Georgia) | Secondary |
| Provider Name | Magnolia Comfort Medical, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1154940906 PECOS PAC ID: 9335579374 Enrollment ID: O20201230000332 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kevin T Le, DC 4935 Jimmy Carter Blvd Ste 360, Norcross, GA 30093-3536 Ph: (470) 545-0275 | Dr Kevin T Le, DC 4935 Jimmy Carter Blvd Ste 360, Norcross, GA 30093-3536 Ph: (470) 545-0275 |
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