Individual
RONALD LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
140 S GILBERT RD, GILBERT, AZ 85296-1016
(480) 558-5131
Mailing address
1510 W SAND COVE DR, GILBERT, AZ 85233-6536
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4244
AZ
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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