Individual
ISAIAH SHANE LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
179 STATION PL, HURRICANE, WV 25526-6578
(304) 760-6300
Mailing address
179 STATION PL, HURRICANE, WV 25526-6578
(304) 760-6300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2469
WV
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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