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Individual

IAN MICHAEL LEAHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
207 STADIUM ST, SMYRNA, DE 19977-2899
(302) 659-0173
(302) 659-0424
Mailing address
1812 MARSH RD, STORE 505, WILMINGTON, DE 19810-4581
(302) 793-0432
(302) 793-0400

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10002392
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1932355328
DE
01
3634428000
IBC AMERIHEALTH
Enumeration date
08/18/2008
Last updated
03/02/2010
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