Individual
NICOLETTE LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3701 BELLEMEADE AVE, EVANSVILLE, IN 47714-0137
(812) 479-1411
Mailing address
443 S LANDMARK AVE, BLOOMINGTON, IN 47403-5004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013493A
IN
Other
Enumeration date
08/09/2019
Last updated
02/06/2024
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