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Organization
CRYSTAL LEACH, MD PHYSIATRY AND ASSOCIATES LLC
Active
Organization
CRYSTAL LEACH, MD PHYSIATRY AND ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL IVAHNA LEACH MD (MANAGER/MEMBER/OWNER/PHYSICIAN)
(504) 915-3461
Entity
Organization
Contact information
Practice address
17351 MELFORD BLVD, BOWIE, MD 20715-4457
(240) 548-1300
(240) 548-1695
Mailing address
1296 CRONSON BLVD, UNIT 4444, CROFTON, MD 21114-9998
(504) 915-3461
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
05/27/2023
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