Individual
MELISSA D. LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7160 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9266
(662) 349-2733
Mailing address
7160 TCHULAHOMA ROAD, SOUTHAVEN, MS 38671
(662) 349-2733
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT4623
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT4623
MS
MS
Enumeration date
09/15/2009
Last updated
09/15/2009
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