Individual
KIM LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4247 WESTPORT RD, LOUISVILLE, KY 40207-2227
(502) 694-7432
Mailing address
4247 WESTPORT RD, LOUISVILLE, KY 40207-2227
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
28163506A
IN
Other
Enumeration date
12/22/2022
Last updated
12/22/2022
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