Individual
AMY LEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 NW EXPRESSWAY STE 809, OKLAHOMA CITY, OK 73112-5466
(866) 848-8813
Mailing address
3030 NW EXPRESSWAY STE 809, OKLAHOMA CITY, OK 73112-5466
(866) 848-8813
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2297
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OKL1S09650
AGILE HEALTH INSURANCE
OK
Enumeration date
05/30/2016
Last updated
05/31/2016
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