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Individual

JORDAN BENJAMIN LEYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA, M.M.S

Contact information

Practice address
1755 S GRAND BLVD, SAINT LOUIS, MO 63104-1540
(636) 352-5416
Mailing address
944 OLDE FARM RD, TROY, IL 62294-3128

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
04/01/2020
Last updated
04/01/2020
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