Individual
JESSICA LEITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4838 E BASELINE RD, SUITE 105, MESA, AZ 85206-4671
(480) 890-9000
(480) 890-9100
Mailing address
4838 E BASELINE RD, SUITE 105, MESA, AZ 85206-4671
(480) 890-9000
(480) 890-9100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2125
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0461740
BCBS PROVIDER #
AZ
Enumeration date
05/23/2006
Last updated
05/08/2008
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