Individual
AMY LEITNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1001 GATEWAY AVE, BISMARCK, ND 58503-0508
(701) 214-0204
Mailing address
1001 GATEWAY AVE, BISMARCK, ND 58503-0508
(701) 214-0204
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1019
ND
Other
Enumeration date
12/28/2011
Last updated
12/28/2011
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