Individual
AMY LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400C OLD MILTON PARKWAY, STE 390, ALPHARETTA, GA 30005
(770) 410-7669
Mailing address
5400 LEXINGTON WOODS LN, ALPHARETTA, GA 30005-8905
(770) 751-0875
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT008355
LICENSE #
GA
Enumeration date
09/05/2006
Last updated
07/08/2007
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