Individual
ANDREA LEEDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, PCS
Contact information
Practice address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
(406) 549-6413
Mailing address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
(406) 549-6413
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PT00009521
WA
2251P0200X
Pediatric Physical Therapist
Primary
PTP-PT-LIC-2287
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002346
—
MT
05
—
7018120
—
WA
Enumeration date
03/26/2007
Last updated
12/14/2022
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