Provider Demographics
NPI:1033696703
Name:LD RECOVERY SOLUTIONS, INC.
Entity type:Organization
Organization Name:LD RECOVERY SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-439-6772
Mailing Address - Street 1:521 FELLOWSHIP RD STE 155
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3442
Mailing Address - Country:US
Mailing Address - Phone:856-439-6772
Mailing Address - Fax:856-206-0519
Practice Address - Street 1:521 FELLOWSHIP RD STE 155
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3442
Practice Address - Country:US
Practice Address - Phone:856-439-6772
Practice Address - Fax:856-206-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty