MIRANDA N LEACH

GREEN BAY, WI
NPI1770185514
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  3105-19)
Enumeration Date2020-11-16
Last Update Date2020-11-16
Business Address
MIRANDA N LEACH PTA
2547 TROJAN DR
GREEN BAY, WI 54304-1436
Phone number: 573-718-9947
Mailing Address
MIRANDA N LEACH PTA
2547 TROJAN DR
GREEN BAY, WI 54304-1436
Phone number: 573-718-9947
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