Individual
MRS. KELLEY BETH LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1321 CRESTON PARK DR, JANESVILLE, WI 53545-1126
(608) 757-1217
Mailing address
1321 CRESTON PARK DR, JANESVILLE, WI 53545-1126
(608) 757-1217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4967-024
WI
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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