Individual
LYDIA RADERSTORF-LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2108 E BOULEVARD, KOKOMO, IN 46902-2401
(765) 416-8480
(655) 885-4807
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 265-4606
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013831A
IN
Other
Enumeration date
08/07/2020
Last updated
10/11/2021
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