Individual
JESSICA RENEE LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, ATC
Contact information
Practice address
3480 LANDERS RD, NORTH LITTLE ROCK, AR 72117
(501) 955-5519
(501) 955-5529
Mailing address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 978-2623
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT3399
AR
2255A2300X
Athletic Trainer
447
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213203721
—
AR
Enumeration date
09/15/2011
Last updated
01/11/2019
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