Individual
MARY CHARLOTTE LEICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
104 WALNUT LN STE 106, NORTH AUGUSTA, SC 29860-8684
(803) 599-5990
(803) 599-7239
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10484
SC
225100000X
Physical Therapist
PT014874
GA
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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