Individual
BLAKE EDWARD LEEBRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
736 BATTLEFIELD BLVD N, CHESAPEAKE, VA 23320-4941
(757) 312-6151
Mailing address
325 BARCELONA LN, VIRGINIA BEACH, VA 23452-5415
(757) 504-6741
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000457
VA
Other
Enumeration date
11/10/2023
Last updated
11/13/2023
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