Individual
TRACI L LEITHEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 312-2373
(605) 312-9802
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/06/2021
Last updated
10/13/2021
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