Individual
MICHAEL LEEPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7640 N WICKHAM RD STE 110, MELBOURNE, FL 32940-8147
(321) 259-9606
Mailing address
1413 LARAMIE CIR, MELBOURNE, FL 32940-6372
(321) 427-6472
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA19023
LICENSE #
FL
Enumeration date
08/30/2006
Last updated
07/08/2007
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