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1093305146
AMANDA MARIE LEAK
PETERSON AFB, CO
NPI
1093305146
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
126800000X Dental Assistant
Enumeration Date
2021-01-22
Last Update Date
2021-01-22
Business Address
AMANDA MARIE LEAK
1055 E STEWART AVE BLDG 2018
PETERSON AFB, CO 80914-2900
Phone number: 719-556-1333
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Mailing Address
AMANDA MARIE LEAK
5055 SODBUSTER TRL
COLORADO SPRINGS, CO 80917-1715
Phone number: 406-868-0180
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