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Individual

LEANNE M UNDERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
2940 E BANNER GATEWAY DR, SUITE 200, GILBERT, AZ 85234-2168
(480) 964-2908
(480) 833-2136
Mailing address
PO BOX 29870, PHOENIX, AZ 85038-9870
(480) 964-2908
(480) 833-2136

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9551
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
654044
AZ
01
P01001425
RAILROAD MEDICARE
AZ
Enumeration date
10/03/2011
Last updated
07/05/2013
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