Individual
DR. COREY THOMAS LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2826 E BASELINE RD # 101, MESA, AZ 85204-7282
(480) 626-8925
Mailing address
2826 E BASELINE RD # 101, MESA, AZ 85204-7282
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2209DT
KY
152W00000X
Optometrist
Primary
OPT-002774
AZ
152WC0802X
Corneal and Contact Management Optometrist
2209DT
KY
152WS0006X
Sports Vision Optometrist
2209DT
KY
Other
Enumeration date
10/26/2020
Last updated
04/04/2024
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