Individual
JESSICA LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6120 HICKORY FLAT HWY, CANTON, GA 30115-7252
(770) 720-0610
Mailing address
6120 HICKORY FLAT HWY, CANTON, GA 30115-7252
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN245676
GA
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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