Individual
PHILLIP LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
490 ALYSIA CT, APT 207, ROCK HILL, SC 29732-6537
(803) 530-1859
Mailing address
490 ALYSIA CT, APT 207, ROCK HILL, SC 29732-6537
(803) 530-1859
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1502
—
Other
Enumeration date
08/13/2014
Last updated
10/07/2014
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