Individual
KELLY J LEECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 BROAD ST, JOHNSTOWN, PA 15906
(814) 248-7901
Mailing address
401 BROAD ST, JOHNSTOWN, PA 15906
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI001781
PA
Other
Enumeration date
07/19/2013
Last updated
07/19/2013
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