Individual
MR. BO C LEONARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, MS
Contact information
Practice address
906 S STATE ST, LOCKPORT, IL 60441-3436
(708) 283-9765
Mailing address
906 S STATE ST, LOCKPORT, IL 60441-3436
(708) 283-9765
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/16/2006
Last updated
07/08/2007
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