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Individual

TERRY R LEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1577 GOODMAN AVE STE B, CINCINNATI, OH 45224-1044
(513) 729-1321
(513) 729-2873
Mailing address
2865 CHANCELLOR DR, SUITE 215, CRESTVIEW HILLS, KY 41017-3912
(859) 344-2079
(859) 581-7207

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4416
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0095608
OH
Enumeration date
08/29/2006
Last updated
12/17/2021
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