Individual
JASMINE SYMONE LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
16367 ENCLAVE VILLAGE DR, TAMPA, FL 33647-5105
(478) 320-7022
Mailing address
16367 ENCLAVE VILLAGE DR, TAMPA, FL 33647-5105
(478) 320-7022
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/01/2021
Last updated
06/01/2022
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