Individual
MRS. KELLY OH LECKRONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
19032 MAGNOLIA ST, HUNTINGTON BEACH, CA 92646-2232
(714) 968-3003
Mailing address
268 S LEMON ST, ORANGE, CA 92866-1805
(714) 514-2701
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT 34054
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 34054
PT LICENSE
CA
Enumeration date
10/11/2007
Last updated
10/20/2011
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