Individual
LUC DAY LEECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1957 ALVIN RICKEN DR, POCATELLO, ID 83201-2727
(208) 406-4067
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1977
ID
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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