Individual
MS. JODY J LEISHOLMN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
563 BRENDIBLE ST., METLAKATLA, AK 99926
(907) 886-4741
Mailing address
PO BOX 675, METLAKATLA, AK 99926-0675
(907) 886-1970
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
698
AK
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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