Individual
BRADY LATHAM LEISSNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1014 N NOLAN RIVER RD UNIT B, CLEBURNE, TX 76033-7936
(817) 406-1408
Mailing address
2051 MAYFIELD PKWY APT 1221, CLEBURNE, TX 76033-4226
(325) 493-8990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1360214
TX
261QP2000X
Physical Therapy Clinic/Center
1360214
TX
Other
Enumeration date
05/19/2022
Last updated
11/29/2022
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