Individual
BRIAN WILLIAM LEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2270 DOUGLAS BLVD, ROSEVILLE, CA 95661-3869
(916) 289-8172
Mailing address
2270 DOUGLAS BLVD, ROSEVILLE, CA 95661-3869
(916) 289-8172
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160939805
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2
N/A
WA
Enumeration date
08/26/2019
Last updated
08/26/2019
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