Individual
MRS. TERRYLYNN LEISSRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2805 W OLD HIGHWAY 91, INKOM, ID 83245-1601
(208) 775-3097
(208) 775-3097
Mailing address
2805 W OLD HIGHWAY 91, INKOM, ID 83245-1601
(208) 775-3097
(208) 775-3097
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
W36708
ID
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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