Individual
JENNIFER A LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5409 N KNOXVILLE AVE, STE 400, PEORIA, IL 61614
(309) 692-6644
(309) 692-3320
Mailing address
5401 N KNOXVILLE, STE 400, PEORIA, IL 61614-5021
(309) 692-6644
(309) 692-3320
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002608
IL
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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