Individual
JENNIE A LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
240 MAPLE ST, WOODRUFF, WI 54568-0470
(715) 356-8000
Mailing address
240 MAPLE ST, PO BOX 470, WOODRUFF, WI 54568-0470
(715) 356-8000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
41726-020
WI
208600000X
Surgery Physician
41726-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34014300
—
WI
Enumeration date
07/03/2006
Last updated
06/13/2014
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