| Doctor Name: | LESLEY D LOOPER |
| NPI Number: | 1386920502 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | TL1702 |
| Business Practice Address: | 309 W Butler Rd Mauldin, SC - 296622531 |
| Business Phone Number: | 8642971575 |
| Business Fax Number: | 8642976256 |
| Mailing Address: | 11 Arden St, GREENVILLE |
| State: | SC |
| Postal Code: | 296071704 |
| Phone Number: | 8647843442 |
| Fax Number: | |
| NPI Enumeration Date: | 11/02/2011 |
| NPI Last Update Date: | 11/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | TL1702 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |