Individual
ELLIE LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 BLUE HERON LN, FORT PIERCE, FL 34982-8049
(423) 432-1331
Mailing address
1804 BLUE HERON LN, FORT PIERCE, FL 34982-8049
(423) 432-1331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/30/2015
Last updated
08/30/2015
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