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Organization
DPMLEONHEARTPRWA LLC
Active
Organization
DPMLEONHEARTPRWA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC EDWARD LEONHEART (OWNER)
(253) 841-3668
Entity
Organization
Contact information
Practice address
10116 116TH ST E, SUITE 103, PUYALLUP, WA 98373-3543
(253) 841-3668
Mailing address
11201 88TH AVE E, SUITE 210, PUYALLUP, WA 98373-3802
(253) 841-3668
(253) 841-0878
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO00000778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1121714
—
WA
Enumeration date
11/16/2007
Last updated
10/10/2008
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