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MR. JERRY WAYNE LEISURE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA C

Contact information

Practice address
108 6TH ST, WINFIELD, TX 75493
(903) 524-4700
(903) 524-4900
Mailing address
1363W SPRUCE AVE, WASILLA, AK 99654-5327
(907) 376-2411
(907) 352-3363

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00032
TX

Other

Enumeration date
05/14/2007
Last updated
07/10/2015
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